Color Doppler energy prediction of malignancy in adnexal masses using logistic regression models.

OBJECTIVE: The aim of this study was to assess the usefulness of color Doppler energy in the preoperative diagnosis of ovarian malignancy using multivariate logistic regression analysis. METHODS: One hundred and thirty adnexal masses were studied with transvaginal B-mode, color energy, and pulsed Doppler ultrasonography before surgery in order to develop a model that could be used to determine malignancy. Each ultrasonographic variable (tumor size, wall thickness, septal structure, echogenicity, papillary projection, density (solid or not)) was included individually or combined together as part of the Sassone ultrasound score. Intratumoral blood flow velocity waveforms were obtained to determine pulsatility index and resistance index and a more subjective parameter, location of tumor vascularity, was also assessed. Menopausal status and serum CA 125 levels were also entered as categorical variables. Sonographic parameters were entered alone, then associated with menopausal status and CA 125 serum levels, and finally with Doppler energy measurements. Our model was then validated in a group of 68 adnexal masses and compared to the model of Alcazar. RESULTS: Eighteen adnexal masses (13.8%) were malignant or of low malignant potential. Multivariate analysis showed that papillary projection of the tumor wall, cyst with solid parts, resistance index with a cut-off value of 0.53, CA 125, and central blood flow location, were the only factors to be independent predictors of malignancy. Menopausal status was not an independent factor. For the final model including the Doppler energy parameter the best sensitivity and specificity were 83% and 93%, respectively, at a cut-off value of 10% probability of malignancy compared to 83% and 87% for the morphological variables alone. Validation of the model showed its diagnostic performance to be as good as that reported in the original population and better than the model of Alcazar. CONCLUSION: Sonographic analysis of adnexal masses including color Doppler energy shows the best predictive properties according to histological diagnosis, and improves preoperative diagnosis of malignancy.

[The monitoring of gas bubbles with a pulsed Doppler ultrasonic locator in humans working in a space suit]. / Monitoring gazovykh puzyr'kov ul'trazvukovym impul'sno-dopplerovskim lokatorom u cheloveka pri rabote v skafandre.

Presented are results of gas bubbles monitoring in decompressed humans with the use of an ultrasonic pulse-Doppler locator (PDL). Unlike the classic Doppler bubbles detectors with continuous US emission, PDL is adjusted for reception of echo from a chosen volume of the right ventricle cavity; thus, the clutter due to cardiac beats and human locomotion is successfully rejected. During simulation of Russian EVAs, venous gas bubbles were detected in 3 out of 5 experiments with test-subjects clothed in everyday wear and in 2 out of 3 experiments with suited test-subjects.

Use and limitations of immediate postprocedural intracoronary Doppler blood flow measurements for predicting late result after coronary balloon angioplasty. Results of a pilot study.

BACKGROUND AND AIMS: Physiologic measurement of myocardial perfusion in the immediate postangioplasty period may complement the angiographic assessment of the outcome of the procedure and improve our ability to identify patients at increased risk for a suboptimal late result. Immediate in-lab identification of patients at risk for late coronary restenosis would allow the interventionalist to implement alternate interventional and/or pharmacologic strategies aimed at improving the long-term outcome of angioplasty. The present single-center pilot study was undertaken to examine prospectively the value of intracoronary Doppler flow measurements immediately postangioplasty for predicting long-term patency of the dilated coronary artery. PATIENTS AND METHODS: Coronary average peak flow velocity (APV) at rest and during hyperemia (6-18 micrograms intracoronary adenosine) and coronary flow reserve in the distal coronary segment were measured in 24 consecutive patients 10-15 min after successful elective coronary angioplasty. Volume flow (Q) was calculated as APV/2 coronary cross-sectional area heart rate. Coronary arterial vessels and narrowings were measured by quantitative angiography using a geometric based method and automated edge detection. The present study reports the findings in the 16 patients undergoing conventional balloon angioplasty for whom hard endpoint angiographic data were available 4.9 +/- 1.5 months after angioplasty. RESULTS: A linear relation was present between angiographically measured minimal luminal dimension immediately postangioplasty and the late angiographic result of the procedure (r = 0.71, p = 0.0005). A greater acute gain during angioplasty was predictive of a larger luminal dimension at late angiographic follow-up (p = 0.006). There was no relation between the immediate postangioplasty Doppler flow measurements and the late angiographic result of the procedure. Late luminal dimension was not related to immediate postangioplasty basal or hyperemia APV, nor to immediate postangioplasty basal or hyperemic volume flow or to coronary flow reserve (all NS). CONCLUSIONS: In this single-center study, intracoronary blood flow and Doppler-derived coronary flow reserve immediately postpercutaneous transluminal coronary angioplasty were not predictive of long-term vessel patency or late coronary restenosis. The immediate angiographic result of angioplasty did correlate with the late result of the procedure.

Estudo comparativo eentre os índices dopplervelocimétrico obtidos em diferentes locais de insonaçäo do cordäo umbilical / Comparative study between the dopplervelocimetric index obtaines in different sites of insomnation of umbilical cord

Os autores fizeram um estudo prospectivo onde analisaram e compararam o índice de resistência da artéria umbilical obtido em pontos extremos do cordÝo. A análise estatística mostrou significância importante, ou seja, o índice de resistência da artéria umbilical junto a placenta sempre se mostrou mais baixo quando comparada à regiÝo junto ao abdome fetal. Os autores terminam o trabalho alertando que o local de insonaçÝo da artéria umbilical é um fator técnico importante, e portanto deve ser padronizado pelos ultra-sonografistas

Mola parcial: diagnóstico por angiografía ultrasónica y Doppler pulsado, seguimiento y resultado perinatal / Parcial mole: diagnostic by ultrasonic angiography and pulsate Doppler, following and perinatal result

Se presenta un caso de Mola Parcial cuyo diagnóstico definitivo se realizó mediante angiografía ultrasónica. La uteroinhibición con Progesterona micronizada permitió llegar a las 30 semanas con parto espontáneo y un exitoso resultado perinatal