ABSTRACT
The quality standards of the French Society of Vascular Medicine for the ultrasonographic assessment of vascular malformations are based on the two following requirements: (1) technical know-how: mastering the use of ultrasound devices and the method of examination; (2) medical know-how: ability to adapt the methods and scope of the examination to its clinical indication and purpose, and to rationally analyze and interpret its results. AIMS OF THE QUALITY STANDARDS: To describe an optimal method of examination in relation to the clinical question and hypothesis. To homogenize practice, methods, glossary, and reporting. To provide good practice reference points, and promote a quality process. ITEMS OF THE QUALITY STANDARDS: The 3 levels of examination; their clinical indications and goals. The reference standard examination (level 2), its variants according to clinical needs. The minimal content of the examination report; the letter to the referring physician (synthesis, conclusion and proposal for further investigation and/or therapeutic management). Commented glossary (anatomy, hemodynamics, semiology). Technical bases. Setting and use of ultrasound devices. Here, we discuss ultrasonography methods of using of ultrasonography for the assessment of peripheral vascular malformations and tumors (limbs, face, trunk).
Subject(s)
Ultrasonography, Doppler, Duplex/standards , Vascular Malformations/diagnostic imaging , Vascular Neoplasms/diagnostic imaging , Adult , Blood Coagulation Disorders/blood , Blood Coagulation Disorders/etiology , Blood Flow Velocity , Clinical Competence , Disease Progression , Eye Neoplasms/diagnostic imaging , Female , Fibrin Fibrinogen Degradation Products/analysis , Fibrinogen/analysis , Hemangioma/diagnostic imaging , Hemodynamics , Humans , Infant , Lymphangioma, Cystic/diagnostic imaging , Male , Quality Assurance, Health Care , Ultrasonography, Doppler, Color/instrumentation , Ultrasonography, Doppler, Color/methods , Ultrasonography, Doppler, Duplex/instrumentation , Ultrasonography, Doppler, Duplex/methods , Vascular Malformations/blood , Vascular Malformations/classification , Vascular Malformations/complicationsABSTRACT
THE QUALITY STANDARDS OF THE FRENCH SOCIETY OF VASCULAR MEDICINE FOR THE ULTRASONOGRAPHIC ASSESSMENT OF VASCULAR MALFORMATIONS ARE BASED ON THE TWO FOLLOWING REQUIREMENTS: Technical know-how: mastering the use of ultrasound devices and the method of examination. Medical know-how: ability to adapt the methods and scope of the examination to its clinical indication and purpose, and to rationally analyze and interpret its results. AIMS OF THE QUALITY STANDARDS: To describe an optimal method of examination in relation to the clinical question and hypothesis. To achieve consistent practice, methods, glossary, and reporting. To provide good practice reference points, and promote a high-quality process. ITEMS OF THE QUALITY STANDARDS: The three levels of examination; their clinical indications and goals. The reference standard examination (level 2), its variants according to clinical needs. The minimal content of the examination report; the letter to the referring physician (synthesis, conclusion and proposal for further investigation and/or therapeutic management). Commented glossary (anatomy, hemodynamics, semiology). Technical bases. Settings and use of ultrasound devices. Here, we discuss the methods of using ultrasonography for the assessment of peripheral vascular malformations and tumors.
Subject(s)
Quality Assurance, Health Care , Ultrasonography, Doppler/standards , Vascular Malformations/diagnostic imaging , Vascular Neoplasms/diagnostic imaging , Arm/blood supply , Arteries/diagnostic imaging , Hemangioma/diagnostic imaging , Humans , Leg/blood supply , Lymphangioma/diagnostic imaging , Physical Examination/methods , Physical Examination/standards , Ultrasonography, Doppler/instrumentation , Ultrasonography, Doppler/methods , Ultrasonography, Doppler, Color/methods , Ultrasonography, Doppler, Color/standards , Ultrasonography, Doppler, Pulsed/methods , Ultrasonography, Doppler, Pulsed/standards , Ultrasonography, Interventional/standards , Vascular Malformations/classification , Veins/diagnostic imaging , Venous Thrombosis/diagnostic imagingABSTRACT
New insight has recently been obtained into the molecular mechanisms regulating lymphatic development and function during embryogenesis. VEGF-C and D ligands have been shown to stimulate lymphangiogenesis and their lymphatic-specific receptor VEGFR-3 is linked to the human congenital and hereditary lymphedema in humans. Above all, new focus on lymphatic endothelial cells gives opportunities for developing innovative therapies for lymphedema and cancer metastasis.
Subject(s)
Endothelial Growth Factors/genetics , Lymphedema/genetics , Lymphedema/physiopathology , Endothelial Growth Factors/pharmacology , Humans , Ligands , Lymph , Neoplasm Metastasis , Neoplasms/complications , Vascular Endothelial Growth Factor C , Vascular Endothelial Growth Factor DABSTRACT
The case reported here, concerns a spontaneous low-flow fistula between the external carotid arterial network and the cavernous sinus, with ophthalmological symptoms (exophthalmos, red eye) in an old woman with cardiac failure. The shunt was diagnosed by color-Doppler-imaging, which showed a flow reversal with a systolic component in the superior and inferior enlarged ophthalmic veins. This finding led the authors to extend the arterial filling sequence since the shunt was not detectable on standard arterial views. Embolization was performed during angiography which remains necessary to localize the shunt and to treat the fistula. The clinical symptoms progressively returned to normal and the correction of the hemodynamic disturbances could be followed by color-Doppler imaging, a non-invasive technique which can be easily repeated.
