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Sample records for contrast-enhanced color doppler

  1. Monitoring of hepatocellular carcinoma, following proton radiotherapy, with contrast-enhanced color Doppler ultrasonography.

    PubMed

    Niizawa, Gaku; Ikegami, Tadashi; Matsuzaki, Yasushi; Saida, Yukihisa; Tohno, Eriko; Kurosawa, Takashi; Saito, Yoshifumi; Chiba, Toshiya; Kita, Yasuyo; Tokuuye, Koichi; Akine, Yasuyuki; Tanaka, Naomi

    2005-03-01

    We have reported that proton radiotherapy for hepatocellular carcinoma (HCC) is a safe and effective therapeutic option. However, it is difficult to evaluate its effect in certain cases. Recently, it has been reported that the usage of contrast-enhanced color Doppler ultrasonography (CECDU) can improve diagnostic accuracy, both in terms of the presence of hepatic tumor and in the evaluation of treatment. The aim of this study was to determine the usefulness of CECDU in assessing the therapeutic response of HCC treated with proton radiotherapy. Twenty-two patients treated with the proton radiotherapy were studied. We inspected HCC lesions by CECDU, before and after the irradiation, over time. The magnitude of blood flow in the HCC was quantified on still images by CECDU. The ratio of the number of color pixels against that of the total number of pixels in the tumor area was defined as the tumor blood flow ratio (TBFR). Immediately after the proton treatment, a transient increase of blood flow in the tumor was recognized in more than half of the patients, while the TBFR was unchanged or decreased in the remaining patients. At longer periods after irradiation, the TBFR in all HCCs gradually decreased, and this reduction of TBFR was statistically significant from 9 months after irradiation. These findings are consistent with those obtained previously by computed tomography (CT) as well as magnetic resonance imaging (MRI). We propose CECDU as a useful diagnostic option for the evaluation of HCC treated with proton radiotherapy.

  2. Diagnostic vascular ultrasonography with the help of color Doppler and contrast-enhanced ultrasonography

    PubMed Central

    2016-01-01

    The use of ultrasonography and especially of contrast-enhanced ultrasonography (CEUS) in the diagnosis of vascular pathologies before and after interventions has significantly increased over the past years due to the broader availability of modern ultrasound systems with CEUS capabilities and more trained user experience in this imaging modality. For the preinterventional and postinterventional work-up of carotid diseases, duplex ultrasound as well as CEUS have been established as the standard-of-care examination procedures for diagnosis, evaluation, and follow-up. In addition to its use for carotid arterial diseases, ultrasonography has also become the primary modality for the screening of vascular pathologies. This review describes the most common pathologies found in ultrasonography of the carotid arteries, the abdominal aorta, and the femoral arteries. PMID:27669962

  3. Global testicular infarction in the presence of epididymitis: clinical features, appearances on grayscale, color Doppler, and contrast-enhanced sonography, and histologic correlation.

    PubMed

    Yusuf, Gibran; Sellars, Maria E; Kooiman, Gordon G; Diaz-Cano, Salvador; Sidhu, Paul S

    2013-01-01

    Epididymitis is common, presenting indolently with unilateral scrotal pain and swelling. Diagnosis is based on clinical assessment and resolves with antibiotic therapy. Recognized complications are abscess formation and segmental infarction. Global testicular infarction is rare. Diagnosis is important and requires surgical management. On grayscale sonography, global infarction may be difficult to establish. The addition of color Doppler imaging is useful but is observer experience dependent with limitations in the presence of low flow. Contrast-enhanced sonography is useful for unequivocally establishing the diagnosis. We report global testicular infarction in 2 patients with epididymitis clearly depicted on contrast-enhanced sonography, allowing immediate surgical management.

  4. Local adaptive contrast enhancement for color images

    NASA Astrophysics Data System (ADS)

    Dijk, Judith; den Hollander, Richard J. M.; Schavemaker, John G. M.; Schutte, Klamer

    2007-04-01

    A camera or display usually has a smaller dynamic range than the human eye. For this reason, objects that can be detected by the naked eye may not be visible in recorded images. Lighting is here an important factor; improper local lighting impairs visibility of details or even entire objects. When a human is observing a scene with different kinds of lighting, such as shadows, he will need to see details in both the dark and light parts of the scene. For grey value images such as IR imagery, algorithms have been developed in which the local contrast of the image is enhanced using local adaptive techniques. In this paper, we present how such algorithms can be adapted so that details in color images are enhanced while color information is retained. We propose to apply the contrast enhancement on color images by applying a grey value contrast enhancement algorithm to the luminance channel of the color signal. The color coordinates of the signal will remain the same. Care is taken that the saturation change is not too high. Gamut mapping is performed so that the output can be displayed on a monitor. The proposed technique can for instance be used by operators monitoring movements of people in order to detect suspicious behavior. To do this effectively, specific individuals should both be easy to recognize and track. This requires optimal local contrast, and is sometimes much helped by color when tracking a person with colored clothes. In such applications, enhanced local contrast in color images leads to more effective monitoring.

  5. Contrast-enhanced ultrasound in combination with color Doppler ultrasound can improve the diagnostic performance of focal nodular hyperplasia and hepatocellular adenoma.

    PubMed

    Kong, Wen-Tao; Wang, Wen-Ping; Huang, Bei-Jian; Ding, Hong; Mao, Feng; Si, Qin

    2015-04-01

    The aim of our study was to evaluate the value of combining color Doppler ultrasound (CDUS) with contrast-enhanced ultrasound (CEUS) in identifying and comparing features of focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA). Thirty-eight patients with FNH (n = 28) or HCA (n = 10), whose diagnoses were later confirmed by pathology, were examined with conventional ultrasonography and CEUS between 2010 and 2013. Two doctors blinded to the pathology results independently reviewed the conventional ultrasound and CEUS images and then reached a consensus through discussion. The following parameters evaluated for all lesions included vascularity pattern on CDUS or CEUS, enhancement characteristics on CEUS and the presence of a central scar. Statistical analysis was performed with the independent sample t-test and Fisher exact test. On CDUS, FNH was characterized by the presence of abundant blood flow signals exhibiting dendritic (53.6%, 15/28) and spoke-wheel (28.6%, 8/28) patterns, whereas blood flow signal of HCA was slightly less than FNH and often showed subcapsular short rod-like (50%, 5/10) appearance. On CEUS, the most common arterial enhancement pattern was centrifugal or homogeneous enhancement in FNH (both, 12/28, 42.9%) and homogeneous enhancement in HCA (6/10, 60%). Spoke-wheel arteries, feeding artery and central scar were detected in 5 (17.9%), 8 (28.6%) and 5 (17.9%) of 28 FNHs. Hypo-echogenic pattern during delayed phase was more common in HCA (60%, 6/10) than in FNH (3/28, 10.7%) (p = 0.010). A total of 25 (25/38, 65.8%) lesions were correctly assessed using CDUS in combination with CEUS, whereas the number decreased to 15 (15/38, 39.5%) when CDUS was used alone (p = 0.038). The areas under the ROC curves before and after CEUS administration were 0.768 and 0.879, respectively. In conclusion, CEUS in combination with CDUS improve the diagnostic performance of FNH and HCA. Blood signal of HCA was less than FNH on CDUS. The differences of

  6. Hepatocellular Carcinoma Treated with Chemoembolization: Assessment with Contrast-Enhanced Doppler Ultrasonography

    SciTech Connect

    Catalano, Orlando; Esposito, Maria; Lobianco, Roberto; Cusati, Bianca; Altei, Francesco; Siani, Alfredo

    1999-11-15

    Purpose: To report our preliminary experience concerning the use of Doppler ultrasonography (DUS) techniques after intravenous injection of the galactose-based contrast agent Levovist in the assessment of hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization (TACE). The sonographic findings are correlated with those obtained using iodized oil (Lipiodol) helical computed tomography (CT). Methods: For 7 months we studied 28 patients with cirrhosis and HCC (a total of 43 nodules) who had undergone TACE between 18 and 30 days previously. The lesions were investigated with color Doppler ultrasonography (CDUS) and power Doppler ultrasonography (PDUS), before and after infusion of the echo-contrast agent (300 mg/ml, maximum 1 injection for each nodule, administered at constant velocity within 60-90 sec), and with helical Lipiodol-CT (0-7 days after DUS). In the retrospective analysis, special attention was given to the Doppler signals related to pulsatile intra- and perinodular flow and to the detection of new vessels after contrast agent injection. The signal intensity was graded as 0 (absent), 1 (low), 2 (medium), or 3 (high), while its distribution was classified as peripheral, central, or diffuse. Oily agent retention on CT scans was assessed as 0 (absent), I (<10%), II (<50%), III (>50%), or IV (homogeneous). These scores were awarded separately, without knowledge of the other judgments. Results: An hepatic global echo-enhancing effect was identified in all cases and always lasted long enough to allow an accurate analysis of all parenchymal lesions (at least 8 min). The signal scores could be evaluated in 39 of 43 HCCs, as follows: basal CDUS: grade 0 in 17 lesions, grade 1 in 16, grade 2 in 6; contrast-enhanced CDUS: grade 0 in 12 lesions, grade 1 in 10, grade 2 in 14, grade 3 in 3; basal PDUS: grade 0 in 15 lesions, grade 1 in 13, grade 2 in 9, grade 3 in 2; contrast-enhanced PDUS: grade 0 in 11 lesions, grade 1 in 9, grade 2 in 15

  7. Color contrast enhancement for color night vision based on color mapping

    NASA Astrophysics Data System (ADS)

    Qian, Xiaoyan; Han, Lei; Wang, Yujin; Wang, Bangfeng

    2013-03-01

    The increasing availability and deployment of imaging sensors operating in multiple spectral bands has led to a large research effort in image fusion, bringing a lot of pixel-level color fusion algorithms. Color constancy and color contrast are two important topics for color image fusion. However, there is no work considering these two aspects in the meanwhile. The paper focuses on enhancing the color contrast between targets and their backgrounds and maintaining the color constancy. Firstly, a group of visible and infrared images are rendered with natural colors with color contrast enhancement algorithm. Then a color reference palette is derived from source images and their corresponding fused results. To enrich this palette, the nearest Euclidean distance determines the absent colors. The complete palette can be deployed in real-time to different multi-band image sequences of similar scenes. Experimental results based on different data sets show that the targets are popped out with intense colors while backgrounds present natural color appearance. Some objective analysis also shows that the presented method not only inherits more detail information from source images but also brings bigger color distance when comparing with the existing algorithms.

  8. Can Doppler or contrast-enhanced ultrasound analysis add diagnostically important information about the nature of breast lesions?

    PubMed Central

    Stanzani, Daniela; Chala, Luciano F.; de Barros, Nestor; Cerri, Giovanni G.; Chammas, Maria Cristina

    2014-01-01

    OBJECTIVES: Despite evidence suggesting that Doppler ultrasonography can help to differentiate between benign and malignant breast lesions, it is rarely applied in clinical practice. The aim of this study was to determine whether certain vascular features of breast masses observed by duplex Doppler and color Doppler ultrasonography (before and/or after microbubble contrast injection) add information to the gray-scale analysis and support the Breast Imaging-Reporting and Data System (BI-RADS) classification. METHODS: Seventy solid lesions were prospectively evaluated with gray-scale ultrasonography, color Doppler ultrasonography, and contrast-enhanced ultrasonography. The morphological analysis and lesion vascularity were correlated with the histological results. RESULTS: Percutaneous core biopsies revealed that 25/70 (17.5%) lesions were malignant, while 45 were benign. Hypervascular lesions with tortuous and central vessels, a resistive index (RI)≥0.73 before contrast injection, and an RI≥0.75 after contrast injection were significantly predictive of malignancy (p<0.001). CONCLUSION: The combination of gray-scale ultrasonography data with unenhanced or enhanced duplex Doppler and color Doppler US data can provide diagnostically useful information. These techniques can be easily implemented because Doppler devices are already present in most health centers. PMID:24519198

  9. Review of ultrasonography of malignant neck nodes: greyscale, Doppler, contrast enhancement and elastography

    PubMed Central

    Ying, M.; Bhatia, K.S.S.; Lee, Y.P.; Yuen, H.Y.

    2013-01-01

    Abstract Assessment of neck lymph nodes is essential in patients with head and neck cancers for predicting the patient’s prognosis and selecting the appropriate treatment. Ultrasonography is a useful imaging tool in the assessment of neck lymph nodes. Greyscale ultrasonography assesses the size, distribution, and internal architecture of lymph nodes. Doppler ultrasonography evaluates the intranodal vascular pattern and resistance of lymph nodes. Contrast-enhanced ultrasonography provides information on lymph node parenchymal perfusion. Elastography allows qualitative and quantitative assessment of lymph node stiffness. This article reviews the value of greyscale, Doppler and contrast-enhanced ultrasonography as well as elastography in the assessment of malignant nodes in the neck. PMID:24434158

  10. Concepts and trade-offs in velocity estimation with plane-wave contrast-enhanced Doppler.

    PubMed

    Tremblay-Darveau, Charles; Williams, Ross; Sheeran, Paul; Milot, Laurent; Bruce, Matthew; Burns, Peter

    2016-07-29

    While long Doppler ensembles are, in principle, beneficial for velocity estimates, short acoustic pulses must be used in microbubble contrast-enhanced Doppler to mitigate microbubble destruction. This introduces inherent trade-offs in velocity estimates with autocorrelators, which are studied here. A model of the autocorrelation function adapted to the microbubble Doppler signal, accounting for transit time, the echo frequency uncertainty and contrast-agent destruction is derived and validated in vitro. It is further demonstrated that a local measurement of the center frequency of the microbubble echo is essential in order to avoid significant bias in velocity estimates arising from the linear and nonlinear frequency-dependent scattering of microbubbles, and compensate the inherent speckle nature of the received echo frequency. For these reasons, broadband Doppler estimators (2D autocorrelator, Radon projection) are better suited than simpler narrowband estimators (1D autocorrelator, 1D Fourier transform) for contrast-enhanced flow assessment. A case study of perfusion in a VX-2 carcinoma using contrast-enhanced planewave Doppler is also shown. We demonstrate that even when considering all uncertainties associated with microbubble-related decorrelation (destruction, pulse bandwidth, transit time, flow gradient) and the need for real-time imaging, a coefficient of variation of 4% on the an axial velocity is achievable with planewave imaging.

  11. Concepts and Tradeoffs in Velocity Estimation With Plane-Wave Contrast-Enhanced Doppler.

    PubMed

    Tremblay-Darveau, Charles; Williams, Ross; Sheeran, Paul S; Milot, Laurent; Bruce, Matthew; Burns, Peter N

    2016-11-01

    While long Doppler ensembles are, in principle, beneficial for velocity estimates, short acoustic pulses must be used in microbubble contrast-enhanced (CE) Doppler to mitigate microbubble destruction. This introduces inherent tradeoffs in velocity estimates with autocorrelators, which are studied here. A model of the autocorrelation function adapted to the microbubble Doppler signal accounting for transit time, the echo frequency uncertainty, and contrast-agent destruction is derived and validated in vitro. It is further demonstrated that a local measurement of the center frequency of the microbubble echo is essential in order to avoid significant bias in velocity estimates arising from the linear and nonlinear frequency-dependent scattering of microbubbles and compensate for the inherent speckle nature of the received echo frequency. For these reasons, broadband Doppler estimators (2-D autocorrelator and Radon projection) are better suited than simpler narrow-band estimators (1-D autocorrelator and 1-D Fourier transform) for CE flow assessment. A case study of perfusion in a VX-2 carcinoma using CE plane-wave Doppler is also shown. We demonstrate that even when considering all uncertainties associated with microbubble-related decorrelation (destruction, pulse bandwidth, transit time, and flow gradient) and the need for real-time imaging, a coefficient of variation of 4% on the axial velocity is achievable with plane-wave imaging.

  12. Sonographic imaging of extra-testicular focal lesions: comparison of grey-scale, colour Doppler and contrast-enhanced ultrasound

    PubMed Central

    Rafailidis, Vasileios; Robbie, Hasti; Konstantatou, Eleni; Huang, Dean Y; Deganello, Annamaria; Sellars, Maria E; Cantisani, Vito; Isidori, Andrea M

    2016-01-01

    Extra-testicular lesions are usually benign but present with nonspecific grey-scale sonography findings. This study assesses conventional sonographic characteristics in the differentiation of extra-testicular tumoural from inflammatory lesions and whether contrast-enhanced ultrasound has a role. A retrospective database analysis was performed. All patients were examined by experienced sonographers employing standard techniques combining grey-scale, colour Doppler sonography and contrast-enhanced ultrasound. Features recorded were: clinical symptoms, size, location, echogenicity, colour Doppler sonography and contrast-enhanced ultrasound enhancement. Vascularity on colour Doppler sonography and contrast-enhanced ultrasound was graded and compared. The lesions were classified as tumoural or inflammatory. The Chi-square test was used to analyse the sonographic patterns and kappa coefficient to measure the agreement between colour Doppler sonography and contrast-enhanced ultrasound. A total of 30 lesions were reviewed (median diameter 12 mm, range 5–80 mm, median age 52 years, range 18–86 years), including 13/30 tumoural and 17/30 inflammatory lesions. Lesions were hypoechoic (n = 12), isoechoic (n = 6), hyperechoic (n = 2) or mixed (n = 10). Grey-scale characteristics of tumoural vs. inflammatory lesions differed significantly (P = 0.026). On colour Doppler sonography, lesions had no vessels (n = 16), 2–3 vessels (n = 10) and ≥4 vessels (n = 4). On contrast-enhanced ultrasound, lesions showed no vascularity (n = 17), perfusion similar to testis (n = 7) and higher (n = 6). All abscesses identified (n = 9) showed no vascularity on both colour Doppler sonography and contrast-enhanced ultrasound. There was good agreement between these techniques in evaluating vascularity (κ = 0.719) and no significant difference between colour Doppler sonography and contrast-enhanced ultrasound of tumoural vs. inflammatory

  13. Color Doppler sonography in obstetrics and gynecology.

    PubMed

    Fleischer, Arthur C; Andreotti, Rochelle F

    2005-09-01

    This review aims to provide the reader with an overview of the present and future clinical applications in color Doppler sonography for the evaluation of vascularity and blood flow within the uterus (both gravid and nongravid), ovaries, fetus and placenta. The clinical use of color Doppler sonography has been demonstrated within many organ systems. Color Doppler sonography has become an integral part of cardiovascular imaging. Significant improvements have recently occurred, improving the visualization and evaluation of intra-organ vascularity, resulting from enhancements in delineation of tissue detail through electronic compounding and harmonics, as well as enhancements in signal processing of frequency- and/or amplitude-based color Doppler sonography. Spatial representation of vascularity can be improved by utilizing 3D and 4D (live 3D) processing. Greater sensitivity of color Doppler sonography to macro- and microvascular flow has provided improved anatomic and physiologic assessment throughout pregnancy and for pelvic organs. The potential use of contrast enhancement is also mentioned as a means to further differentiate benign from malignant ovarian lesions. The rapid development of these new sonographic techniques will continue to enlarge the scope of clinical applications in a variety of obstetric and gynecologic disorders.

  14. Improved Contrast-Enhanced Power Doppler Using a Coherence-Based Estimator.

    PubMed

    Tremblay-Darveau, Charles; Bar-Zion, Avinoam; Williams, Ross; Sheeran, Paul S; Milot, Laurent; Loupas, Thanasis; Adam, Dan; Bruce, Matthew; Burns, Peter N

    2017-09-01

    While plane-wave imaging can improve the performance of power Doppler by enabling much longer ensembles than systems using focused beams, the long-ensemble averaging of the zero-lag autocorrelation R(0) estimates does not directly decrease the mean noise level, but only decreases its variance. Spatial variation of the noise due to the time-gain compensation and the received beamforming aperture ultimately limits sensitivity. In this paper, we demonstrate that the performance of power Doppler imaging can be improved by leveraging the higher lags of the autocorrelation [e.g., R(1), R(2),…] instead of the signal power (R(0)). As noise is completely uncorrelated from pulse-to-pulse while the flow signal remains correlated significantly longer, weak signals just above the noise floor can be made visible through the reduction of the noise floor. Finally, as coherence decreases proportionally with respect to velocity, we demonstrate how signal coherence can be targeted to separate flows of different velocities. For instance, we show how long-time-range coherence of microbubble contrast-enhanced flow specifically isolates slow capillary perfusion (as opposed to conduit flow).

  15. Echo contrast-enhanced three-dimensional power Doppler of intracranial arteries.

    PubMed

    Postert, T; Braun, B; Pfundtner, N; Sprengelmeyer, R; Meves, S; Przuntek, H; Büttner, T

    1998-09-01

    The purpose of this study was to evaluate the potential of contrast-enhanced three-dimensional (3-D) power Doppler (CE3DPD) in the assessment of intracranial vascular structures, and to compare the results with unenhanced 3-D power Doppler (3DPD) and magnetic resonance angiography (MRA) findings. We insonated 25 patients without cerebrovascular diseases through the temporal bone window using 3DPD and CE3DPD; for comparison, 13 patients underwent MRA. Identification rates of vascular segments and of small branches of intracranial vessels were evaluated by two independent investigators blinded to MRA results. In 21 patients with adequate insonation conditions, CE3DPD significantly improved identification rates compared to 3DPD for the complete visualization of the P1 segment (80.9 vs. 19.0%, p < 0.005, P2 segment (80.9 vs. 42.8%, p < 0.05 and A1 segment (85.7 vs. 38.1%, p < 0.005). Furthermore, CE3DPD depicted, in significantly more examinations, branches of the middle (MCA) and posterior cerebral artery (PCA). Interobserver agreement was higher than 95% for the main intracranial segments and branches of the MCA, but relatively low (80.1-85.7%) for branches of the PCA. In comparison to CE3DPD, MRA identified only parieto-occipital branches of the PCA, temporal branches of the MCA, frontal branches of the anterior cerebral artery and the MCA bifurcation more frequently and accurately. In 4 patients with inadequate acoustic temporal bone windows, the application of a galactose-based microbubble suspension allowed clear 3-D visualization of almost all major intracranial vascular segments and some branches of the large arteries. In conclusion, CE3DPD is a more sensitive ultrasonic tool compared to unenhanced 3-D reconstructions. It makes 3-D ultrasound imaging of the basal cerebral circulation easier to perform and interpret, by providing an improved spatially oriented display of image position. As such, this method may increase operator diagnostic confidence level under

  16. Hue-preserving local contrast enhancement and illumination compensation for outdoor color images

    NASA Astrophysics Data System (ADS)

    Tektonidis, Marco; Monnin, David; Christnacher, Frank

    2015-10-01

    Real-time applications in the field of security and defense use dynamic color camera systems to gain a better understanding of outdoor scenes. To enhance details and improve the visibility in images it is required to per- form local image processing, and to reduce lightness and color inconsistencies between images acquired under different illumination conditions it is required to compensate illumination effects. We introduce an automatic hue-preserving local contrast enhancement and illumination compensation approach for outdoor color images. Our approach is based on a shadow-weighted intensity-based Retinex model which enhances details and compensates the illumination effect on the lightness of an image. The Retinex model exploits information from a shadow detection approach to reduce lightness halo artifacts on shadow boundaries. We employ a hue-preserving color transformation to obtain a color image based on the original color information. To reduce color inconsistencies between images acquired under different illumination conditions we process the saturation using a scaling function. The approach has been successfully applied to static and dynamic color image sequences of outdoor scenes and an experimental comparison with previous Retinex-based approaches has been carried out.

  17. Splanchnic Hemodynamics and Intestinal Vascularity in Crohn's Disease: An In Vivo Evaluation Using Doppler and Contrast-Enhanced Ultrasound and Biochemical Parameters.

    PubMed

    Maconi, Giovanni; Asthana, Anil K; Bolzacchini, Elena; Dell'Era, Alessandra; Furfaro, Federica; Bezzio, Cristina; Salvatore, Veronica; Maier, Jeanette A M

    2016-01-01

    Crohn's disease (CD) is characterized by inflammation and angiogenesis of affected bowel. We evaluated the correlation among vascularity of intestinal wall in CD, splanchnic hemodynamics, clinical activity and biochemical parameters of inflammation and angiogenesis. Sixteen patients with ileal CD and 10 healthy controls were investigated by means of Doppler ultrasound of the superior mesenteric artery and color Doppler and contrast-enhanced ultrasound of the ileal wall. In parallel, serum levels of vascular endothelial growth factor, tumor necrosis factor-α (TNF-α) and nitric oxide, before and 30 min after a standard meal, were evaluated. In CD patients, there was a significant post-prandial reduction in the resistance index and pulsatility index of the superior mesenteric artery, associated with increased levels of nitric oxide and decreased amounts of TNF-α. A correlation was observed between vascular endothelial growth factor and contrast-enhanced ultrasound parameters of intestinal wall vascularity (r = 0.63-0.71, p < 0.05) and between these parameters and superior mesenteric artery blood flow after fasting (resistance and pulsatility indexes: r = -0.64 and -0.72, p < 0.05). Our results revealed a post-prandial increase in nitric oxide and decrease in TNF-α in CD patients in vivo. They also confirm the role of vascular endothelial growth factor in angiogenesis and in pathologic vascular remodeling of CD and its effect on splanchnic blood flow.

  18. Contrast-enhanced power Doppler US in the diagnosis of renal pseudotumors.

    PubMed

    Ascenti, G; Zimbaro, G; Mazziotti, S; Gaeta, M; Lamberto, S; Scribano, E

    2001-01-01

    The term "pseudotumor" is used to refer to several anatomic variants that can simulate a renal mass, the most frequent of which are hypertrophied column of Bertin, persistence of fetal lobation, and the dromedary or splenic hump. We describe the findings of power Doppler US after the ultrasound contrast agent (Levovist, Schering, Berlin, Germany) administration in 4 patients with a renal focal lesion in whom gray-scale and baseline power Doppler US was not able to certainly differentiate pseudotumor from neoplasm.

  19. Programmable Colored Illumination Microscopy (PCIM): A practical and flexible optical staining approach for microscopic contrast enhancement

    NASA Astrophysics Data System (ADS)

    Zuo, Chao; Sun, Jiasong; Feng, Shijie; Hu, Yan; Chen, Qian

    2016-03-01

    Programmable colored illumination microscopy (PCIM) has been proposed as a flexible optical staining technique for microscopic contrast enhancement. In this method, we replace the condenser diaphragm of a conventional microscope with a programmable thin film transistor-liquid crystal display (TFT-LCD). By displaying different patterns on the LCD, numerous established imaging modalities can be realized, such as bright field, dark field, phase contrast, oblique illumination, and Rheinberg illuminations, which conventionally rely on intricate alterations in the respective microscope setups. Furthermore, the ease of modulating both the color and the intensity distribution at the aperture of the condenser opens the possibility to combine multiple microscopic techniques, or even realize completely new methods for optical color contrast staining, such as iridescent dark-field and iridescent phase-contrast imaging. The versatility and effectiveness of PCIM is demonstrated by imaging of several transparent colorless specimens, such as unstained lung cancer cells, diatom, textile fibers, and a cryosection of mouse kidney. Finally, the potentialities of PCIM for RGB-splitting imaging with stained samples are also explored by imaging stained red blood cells and a histological section.

  20. Comparing contrast-enhanced color flow imaging and pathological measures of breast lesion vascularity.

    PubMed

    Forsberg, Flemming; Kuruvilla, Babita; Pascua, Mark B; Chaudhari, Manisha H; Merton, Daniel A; Palazzo, Juan P; Goldberg, Barry B

    2008-09-01

    This study was conducted to compare quantifiable measures of vascularity obtained from contrast-enhanced color flow images of breast lesions to pathologic vascularity measurements. Nineteen patients with solid breast masses received Levovist Injection (10 mL at 300 mg/mL; Berlex Laboratories, Montville, NJ, USA). Color flow images of the mass pre and post contrast were obtained using an HDI 3000 scanner (Philips Medical Systems, Bothell, WA, USA) optimized for clinical scanning on an individual basis. After surgical removal, specimens were sectioned in the same planes as the ultrasound images and stained with an endothelial cell marker (CD31). Microvessel area (MVA) and intratumoral microvessel density (MVD) were determined for vessels 10-19 microm, 20-29 microm, 30-39 microm, 40-49 microm and > or =50 microm in diameter using a microscope and image processing software. From the ultrasound images, the number of color pixels before and after contrast administration relative to the total area of the breast mass was calculated as a first-order measure of fractional tumor vascularity. Vascularity measures were compared using reverse stepwise multiple linear regression analysis. In total, 58 pathology slides (with 8,106 frames) and 185 ultrasound images were analyzed. There was a significant increase in flow visualization pre to post Levovist injection (p = 0.001), but no differences were found between the 11 benign and the eight malignant lesions (p > 0.35). Ultrasound vascularity measurements post contrast correlated significantly with pathology (0.15 < or = r2 < or = 0.46; p < 0.03). The 30-39 microm vessel range contributed most significantly to the MVD relationship (p < 0.001), whereas the MVA was mainly influenced by vessels 20-29 microm (p < 0.004). Precontrast ultrasound only correlated with pathology for relative MVA (r2 = 0.16; p = 0.01). In conclusion, contrast-enhanced color flow imaging provides a noninvasive measure of breast tumor neovascularity

  1. Intracranial collateral pathways assessed by contrast-enhanced three-dimensional transcranial color-coded sonography.

    PubMed

    Wessels, Tiemo; Bozzato, Alessandro; Mull, Michael; Klötzsch, Christof

    2004-11-01

    Individual parameter settings of the duplex machine and limited insonation angles may influence the visualization of small intracranial vessels in 2-D transcranial color-coded sonography. The aim of our study was the morphologic assessment of intracranial collateral pathways (first auditory area celiac artery, A(1)CA; anterior communicating artery, AComA; first parental generation celiac artery P(1)CA; posterior communicating artery, PComA) using 3-D transcranial color-coded duplex sonography (3-D TCCS) and digital subtraction angiography (DSA). A total of 41 patients with large vessel disease and 30 patients who had suffered subarachnoidal hemorrhage (mean age 52 +/- 15 years) were involved. In all patients, angiography was performed within 10 days following 3-D sonography. The patients were investigated with a color-coded duplex system using the power mode. Contrast enhancement was achieved by continuous infusion of a galactose-based echo-enhancer using a perfusor pump. The 3-D system consists of an electromagnet that induces a low-intensity magnetic field near the head of the patient. A magnetic position sensor is attached to the ultrasound (US) probe and transmits the spatial orientation to a personal computer, which also receives the corresponding 2-D images from the video port of the duplex machine. Angiography revealed a "complete" circle of Willis in one third of the patients and, in the remaining patients at least one vessel was hypoplastic or absent. Sufficient temporal bone windows allowed the sonographic investigation of 466 (94%) of 497 expected arterial segments. The comparison of both techniques resulted in a weighted kappa value of 0.56 for the A(1)CA and 0.63 for the AComA. In the posterior circulation kappa values of 0.56 for the P(1)CA and 0.43 for the PComA were calculated. In 50 vessels (10%), 3-D sonography misdiagnosed the diameter of a collateral vessel as normal and angiography revealed hypoplasia or aplasia of this vessel. The main

  2. Color kinesis during contrast-enhanced dobutamine stress echocardiography: feasibility and applicability.

    PubMed

    Takeuchi, Masaaki; Yoshitani, Hidetoshi; Miyazaki, Chinami; Haruki, Nobuhiko; Otani, Shinichiro; Sakamoto, Kazuo; Yoshikawa, Junichi

    2003-01-01

    Accurate interpretation of dobutamine stress echocardiography (DSE) needs expertise. Color kinesis (CK) allows objective assessment of wall motion (WM), and its feasibility and accuracy are enhanced under harmonic imaging with contrast agents. To explore its utility, CK was performed in 41 unselected patients during contrast-enhanced DSE. After bolus injection of Levovist, the CK image was acquired in the apical 4- and 2-chamber views at baseline and peak stress using the ultraharmonic mode. Quad screen format with second harmonic imaging after another injection of Levovist was also obtained as a reference. Regional WM (12 segments in the apical view) was independently assessed by both methods. Heart rate increased from 67 beats/min at baseline to 135 beats/min (88% of age predicted maximal heart rate) at peak stress. The CK image was successfully obtained in all patients at baseline and in 38/41 patients at peak stress. CK tracked endocardial motion accurately in 93% (456/492) of left ventricular segments at baseline and 87% (427/492) at peak stress. The concordance rate of normal and abnormal WM between the 2 methods was 86% (392/456, Kappa 0.61) at baseline and 85% (362/427, kappa 0.53) at peak stress. Among the 38 patients in whom both methods were completed, the standard quad screen display showed abnormal DSE results in 17 patients and 28/114 vascular territories. The sensitivity, specificity and diagnostic accuracy of CK for detecting abnormal findings were, respectively, 71% (12/17), 90% (19/21) and 82% (31/38) in patients and 57% (16/28), 97% (83/86) and 87% (99/114) in vascular territories. The application of CK was highly feasible during contrast-enhanced DSE and gave an objective assessment of WM. This method can be a valuable adjunct to the conventional interpretation of DSE.

  3. Amplitude-coded color doppler: clinical applications.

    PubMed

    Turetschek, K; Kollmann, C; Dorffner, R; Wunderbaldinger, P; Mostbeck, G

    1999-01-01

    Amplitude-coded color Doppler sonography (ACD) has become an useful adjunct to gray-scale US and conventional color Doppler sonography (CD) for the assessment of vascular diseases and pathologic conditions that might affect or alter tissue vascularization or perfusion. Basically, all US units that generate conventional color Doppler information through autocorrelation technique are capable of displaying ACD. This technique is also referred to as power Doppler, amplitude-mode color Doppler US, color Doppler energy (CDE), or US angiography. Amplitude-coded color Doppler sonography has already emerged as a valuable adjunct to conventional CD, particularly for evaluating flow in parts of the body where CD signal is weak because of slow flow, small blood vessels, or both.

  4. [Doppler color in superficial adenopathies].

    PubMed

    Giovagnorio, F

    1999-03-01

    Superficial lymph nodes are frequently involved in different diseases. Their location makes them suitable for effective assessment with high-resolution US and color Doppler has been recently suggested as a tool for increasing sensitivity in lymph node studies. Thus, we investigated the main vascular patterns detectable in abnormal superficial lymph nodes. We evaluated 260 nodes in 180 adult patients; the nodes were located in the cervicofacial ring (78, 30%), internal jugular stations (104, 40%), and supraclavicular (44, 17%), axillary (21, 8%), and inguinal (13, 5%) stations. Color Doppler was performed with 7.5-13 MHz linear transducers, with parameters adjusted for slow-flow detection (5-6 MHz frequency, 700-900 Hz PRF, 50 Hz band filter, high color persistence). Disease assessment required fine-needle biopsy (95 nodes in 95 patients) and clinical follow-up (165 nodes in 85 patients). Fifty-five nodes (21%) presented acute and 130 (50%) chronic inflammation: 75 nodes (29%) were metastatic. The following vascular patterns were detected: a single vascular pole (type I) was seen in chronic inflammation (72% sensitivity, 86% specificity, 57% positive and 92% negative predictive value); an enlarged single vascular pole, with 2-3 enlarged branches (type II) in acute adenitis (80% sensitivity, 81% specificity, 78% positive and 83% negative predictive value); multiple vascular poles with many deformed and displaced branches converging centrally (type III) in metastases (76% sensitivity, 100% specificity, 100% positive and 91% negative predictive value). We conclude that color and power Doppler are useful integrations to B-mode US because they can detect specific signs of malignancy such as peripheral vascular poles and intranodal displacement of vessels.

  5. Comparison of transvaginal color Doppler imaging and color Doppler energy for assessment of intraovarian blood flow.

    PubMed

    Tailor, A; Jurkovic, D; Bourne, T H; Natucci, M; Collins, W P; Campbell, S

    1998-04-01

    To investigate any systematic differences in the analysis of blood flow velocity waveforms derived by color Doppler imaging and color Doppler energy examination of corpora lutea and adnexal tumors, to test whether the accuracy for diagnosing ovarian malignancy differs between end points derived by color Doppler imaging and color Doppler energy, and to compare the reproducibility of flow velocity waveform analysis obtained by both methods. Fifty-six asymptomatic women with presumed corpora lutea and 67 women with known adnexal masses were included in the study. They all were examined using transvaginal sonography with color Doppler imaging and color Doppler energy. Pulsed Doppler sonography was used to obtain flow velocity waveforms to determine the pulsatility index (PI), resistance index (RI), peak systolic velocity, and time-averaged maximum velocity. The tumors were classified retrospectively according to histologic criteria. There were 52 women with benign, three with borderline, and 12 with malignant ovarian tumors. Repeated-measures analysis of variance revealed no systematic differences in the values of all four measurements performed under color Doppler imaging and color Doppler energy for all cases of corpora lutea and adnexal tumors (PI: P=.153, RI: P=.197, peak systolic velocity: P=.355, time-averaged maximum velocity: P=.159). All cases of borderline and malignant tumors had detectable pulsatile blood flow with color Doppler imaging and color Doppler energy. Forty-two (80.8%) of the benign tumors had flow detectable with color Doppler imaging, compared with 40 (76.9%) with color Doppler energy (P=.480). Analysis of receiver operating characteristic curves showed a marginal but nonsignificant improvement in diagnostic performance with color Doppler energy compared with color Doppler imaging for all four measurements (PI: P=.182, RI: P=.178, peak systolic velocity: P=.254, time-averaged maximum velocity: P=.238). The intraclass correlation coefficients

  6. Comparison of dynamic contrast enhanced MRI and Doppler ultrasound in the pre-operative assessment of the portal venous system.

    PubMed

    Naik, K S; Ward, J; Irving, H C; Robinson, P J

    1997-01-01

    The purpose of this study was to compare dynamic contrast enhanced MRI (DCEMR) with Doppler ultrasound (US) in the assessment of portal venous anatomy and to analyse the causes of discrepancy. Over a 1 year period, 97 patients undergoing assessment prior to hepatic surgery underwent imaging of the liver and portal venous system using US with colour and spectral Doppler and MRI with axial T2 weighted spin echo (SE) and coronal oblique T1 weighted rapid gradient echo (GRE) imaging before and immediately after bolus injection of Gd-DTPA (0.1 mmol kg-1). When the US and MRI findings were discrepant, the images were reviewed by two observers and compared with surgical findings. US and DCEMR were concordant in 90 patients (portal vein patent in 80, occluded in 10). In three patients with cirrhosis and gross ascites the portal vein was reported as occluded on US and patent on MRI; surgery confirmed the MRI findings. In one patient the portal vein was patient on US but not on MRI, but there was a 3 week interval between the examinations. In three patients the portal vein was patent on US, but MRI detected occlusion of intrahepatic portal vein branches in two, and encasement of an intrahepatic branch in the third case. Spontaneous splenorenal shunts were seen in 15 patients only on MRI; varices were seen in 39 patients on MRI and in 22 patients on US. Both US and DCEMR contribute to the pre-operative assessment of the portal venous system. MRI provides additional information over US in assessing intrahepatic portal branches and detecting varices and splenorenal shunts, and is recommended for all surgical candidates and in patients with abnormal portal venous anatomy and equivocal US findings.

  7. Epiploic appendagitis: color Doppler sonographic findings.

    PubMed

    Danse, E M; Van Beers, B E; Baudrez, V; Pauls, C; Baudrez, Y; Kartheuser, A; Thys, F; Pringot, J

    2001-01-01

    The aim of this study was to analyze the color Doppler sonographic findings in primary epiploic appendagitis. Color Doppler sonographic findings of ten patients with primary epiploic appendagitis were reviewed. The following sonographic features were analyzed: identification of a mass adjacent to the colonic wall; identification of spotty color areas with arterial flow in this mass and detection of abnormalities of the colonic wall adjacent to the infiltrated fatty tissue. A well-delineated hyperechoic mass adjacent to the colonic wall was detected in each patient with sonography. No colonic wall abnormalities were observed nor color Doppler signal in and around the hyperechoic area. Absence of flow at color Doppler sonography is an additional feature of epiploic appendagitis.

  8. Staggered Multiple-PRF Ultrafast Color Doppler.

    PubMed

    Posada, Daniel; Poree, Jonathan; Pellissier, Arnaud; Chayer, Boris; Tournoux, Francois; Cloutier, Guy; Garcia, Damien

    2016-06-01

    Color Doppler imaging is an established pulsed ultrasound technique to visualize blood flow non-invasively. High-frame-rate (ultrafast) color Doppler, by emissions of plane or circular wavefronts, allows severalfold increase in frame rates. Conventional and ultrafast color Doppler are both limited by the range-velocity dilemma, which may result in velocity folding (aliasing) for large depths and/or large velocities. We investigated multiple pulse-repetition-frequency (PRF) emissions arranged in a series of staggered intervals to remove aliasing in ultrafast color Doppler. Staggered PRF is an emission process where time delays between successive pulse transmissions change in an alternating way. We tested staggered dual- and triple-PRF ultrafast color Doppler, 1) in vitro in a spinning disc and a free jet flow, and 2) in vivo in a human left ventricle. The in vitro results showed that the Nyquist velocity could be extended to up to 6 times the conventional limit. We found coefficients of determination r(2) ≥ 0.98 between the de-aliased and ground-truth velocities. Consistent de-aliased Doppler images were also obtained in the human left heart. Our results demonstrate that staggered multiple-PRF ultrafast color Doppler is efficient for high-velocity high-frame-rate blood flow imaging. This is particularly relevant for new developments in ultrasound imaging relying on accurate velocity measurements.

  9. In vivo imaging of melanoma-implanted magnetic nanoparticles using contrast-enhanced magneto-motive optical Doppler tomography

    NASA Astrophysics Data System (ADS)

    Wijesinghe, Ruchire Eranga; Park, Kibeom; Kim, Dong-Hyeon; Jeon, Mansik; Kim, Jeehyun

    2016-06-01

    We conducted an initial feasibility study using real-time magneto-motive optical Doppler tomography (MM-ODT) with enhanced contrast to investigate the detection of superparamagnetic iron oxide (SPIO) magnetic nanoparticles implanted into in vivo melanoma tissue. The MM-ODT signals were detected owing to the phase shift of the implanted magnetic nanoparticles, which occurred due to the action of an applied magnetic field. An amplifier circuit-based solenoid was utilized for generating high-intensity oscillating magnetic fields. The MM-ODT system was confirmed as an effective in vivo imaging method for detecting melanoma tissue, with the performance comparable to those of conventional optical coherence tomography and optical Doppler tomography methods. Moreover, the optimal values of the SPIO nanoparticles concentration and solenoid voltage for obtaining the uppermost Doppler velocity were derived as well. To improve the signal processing speed for real-time imaging, we adopted multithread programming techniques and optimized the signal path. The results suggest that this imaging modality can be used as a powerful tool to identify the intracellular and extracellular SPIO nanoparticles in melanoma tissues in vivo.

  10. Complete penile corporeal septation: evaluation with contrast enhanced US.

    PubMed

    Bertolotto, Michele; Bucci, Stefano; Quaia, Emilio; Coss, Matteo; Liguori, Giovanni

    2008-01-01

    Complete penile corporeal septation is a rare malformation in which the corpora cavernosa are completely isolated. We describe a new method to reach the diagnosis of this malformation using contrast enhanced US. Two patients with complete penile corporeal septation underwent color Doppler and contrast enhanced US after bilateral cavernosal injection of 10 microg prostaglandin E1. Contrast enhanced US was performed using a contrast specific software (Contrast-Tuned imaging, EsaOte, Genoa, Italy) and a linear transducer designed to evaluate superficial structures. Microbubbles of SonoVue (Bracco, Milan, Italy) were injected in one corpus cavernosum. After cavernosal injection of microbubbles no adverse events were observed. Contrast enhanced US showed unilateral enhancement of the corpus cavernosum in which microbubbles were injected. Cavernosography confirmed unilateral corporeal opacification. Contrast enhanced US can be used effectively to diagnose complete penile corporeal septation.

  11. Scrotal inflammatory disease: color Doppler US findings.

    PubMed

    Horstman, W G; Middleton, W D; Melson, G L

    1991-04-01

    A study of 45 patients with 51 cases of hemiscrotal inflammatory disease was done to determine the color Doppler ultrasonographic appearance of scrotal inflammatory disorders. The diagnosis was ultimately established by means of appropriate response to antibiotic treatment (47 cases) or surgery (four cases). In all cases, there was evidence of hyperemia: an increased number and concentration of detectable vessels in the affected portion of the scrotum. In 17 cases, the gray scale images were normal, and the only evidence of inflammation was the presence of hypervascularity. Abnormally decreased epididymal vascular resistance was detected in 14 cases of epididymitis; abnormally decreased testicular vascular resistance was detected in six cases of orchitis. Spontaneous venous flow was present in 18 patients. The authors conclude that color Doppler can demonstrate the hyperemic response to scrotal inflammatory disease and that, in the proper clinical setting, it can supplement the gray scale findings and increase diagnostic confidence.

  12. Computerized evaluation of echocardiographic stress tests in patients with poorly visualized endocardium using analysis of color-encoded contrast-enhanced images.

    PubMed

    Mor-Avi, Victor; Sugeng, Lissa; Weiss, Robert J; Toledo, Eran; Weinert, Lynn; Bouchard, Tina; Spencer, Kirk T; Lang, Roberto M

    2006-03-01

    We hypothesized that real-time color encoding of contrast-enhanced images would allow objective detection of stress-induced wall motion abnormalities (WMA). We studied 117 patients with poorly visualized endocardium undergoing dobutamine stress tests. Color-encoded images (Philips, color kinesis) were obtained at rest and peak stress in four standard views during i.v. infusion of Definity. Images were reviewed without color overlays by two expert readers, who graded regional wall motion as normal or abnormal. In 101/117 patients (86%), in whom contrast enhancement allowed endocardial tracking, regional fractional area changes were calculated from the color overlays, and thresholds for calling a stress-induced WMA were optimized in a randomly selected subgroup of 34 patients (ROC analysis) to achieve maximum agreement with expert grades. This computerized detection of stress-induced WMA was then tested prospectively in the remaining 67 patients, using the expert grades as a "gold standard". 20/67 patients had resting WMA and 13/67 patients developed WMA at peak stress. The automated technique detected stress-induced WMA in at least one vascular territory with a sensitivity, specificity and accuracy of 0.80, 0.65 and 0.69, while the level of agreement between the two experts was 0.62, 0.91 and 0.85, respectively. Analysis of color-encoded, contrast-enhanced images allows objective, accurate, automated detection of stress-induced WMA in patients with poor acoustic windows.

  13. [Color Doppler sonography of focal abdominal lesions].

    PubMed

    Licanin, Zoran; Lincender, Lidija; Djurović, V; Salihefendić, Nizama; Smajlović, Fahrudin

    2004-01-01

    Color Doppler sonography (CDS--spectral, color and power), harmonic imaging techniques (THI, PHI), possibility of 3D analysis of picture, usage of contrast agents, have raised the values of ultrasound as a diagnostic method to a very high level. THI--non-linear gray scale modality, is based on the processing of higher reflected frequencies, that has improved a picture resolution, which is presented with less artifacts and limiting effects of obesity and gases. Ultrasound contrast agents improve analysis of micro and macro circulation of the examined area, and with the assessment of velocity of supply in ROI (wash in), distribution and time of signal weakening (wash out), are significantly increasing diagnostic value of ultrasound. Besides the anatomical and topographic presentation of examined region (color, power), Color Doppler sonography gives us haemodynamic-functional information on vascularisation of that region, as well as on pathologic vascularisation if present. Avascular aspect of a focal pathologic lesion corresponds to a cyst or haematoma, while coloration and positive spectral curve discover that anechogenic lesions actually represents aneurysms, pseudoaneurysms or AVF. In local inflammatory lesion, abscess in an acute phase, CDS shows first increased, and then decreased central perfusion, while in a chronic phase, a pericapsular vascularisation is present. Contribution of CDS in differentiation of hepatic tumors (hemangioma, HCC and metastasis) is very significant. Central color dots along the peripheral blood vessels and the blush phenomenon are characteristics of capillary hemangioma, peritumoral vascular ring "basket" of HCC, and "detour" sign of metastasis. The central artery, RI from 0.45 to 0.60 and radial spreading characterize FNH. Hepatic adenoma is characterized by an intratumoral vein, and rarely by a vascular hallo. Further on, blood velocity in tumor defined by Color Doppler, distinguishes malignant from benign lesion, where 40 cm/s is a

  14. [Color-Doppler semiology in transplanted kidney].

    PubMed

    Rivolta, R; Castagnone, D; Burdick, L; Mandelli, C; Mangiarotti, R

    1993-05-01

    Color-encoded duplex ultrasonography (CEDU) makes a more accurate technique in kidney graft monitoring by combining real-time US with pulsed Doppler studies of renal vasculature. It is a non-invasive and easy technique. Suitable to study the whole renal artery and vein, CEDU also allows the qualitative and quantitative assessment of the intrarenal vasculature and therefore the easy diagnosis of such vessel dysfunctions as arteriovenous fistulas following biopsy. Moreover, Doppler spectral analysis can be used to distinguish among different causes of renal allograft dysfunction--i.e. rejection, cyclosporine nephrotoxicity or acute tubular necrosis. The value of the resistive index for the differential diagnosis is discussed. CEDU allows a more reliable measurement of renal blood flow thanks to the more precise evaluation of renal artery diameter and mean flow velocity.

  15. [Detection of an intrapulmonary shunt in patients with liver cirrhosis through contrast-enhanced transcranial Doppler. A study of prevalence, pattern characterization, and diagnostic validity].

    PubMed

    Ramírez Moreno, José María; Millán Núñez, María Victoria; Rodríguez Carrasco, Marta; Ceberino, David; Romaskevych-Kryvulya, Olena; Constantino Silva, Ana Belén; Muñoz-Vega, Pedro; García-Corrales, Carmen; Guiberteau-Sánchez, Ana; Roa Montero, Ana; Márquez-Lozano, Patricia; Narváez Rodríguez, Isidoro

    2015-10-01

    Intrapulmonary vascular dilatations (IPVD) are considered a complication of cirrhosis. The technique of choice for their diagnosis is contrast-enhanced echocardiography (CEE). The aim of this study was to determine the usefulness of contrast-enhanced transcranial Doppler (CETD) in the diagnosis of IPVD. We consecutively included patients evaluated for liver transplantation. A cross-sectional study was conducted. The investigator interpreting CETD was blind to the results of the gold standard (CEE). The accuracy of the diagnostic test was evaluated through sensitivity, specificity, positive and negative predictive values, and likelihood ratio. CETD (n=43) showed a right-to-left shunt in 23 patients (62.2%): 4 early, 2 indeterminate and 17 late. Nineteen (51,4%) cases were classified as IPVD. With CEE (n=37), 10 procedures (27%) were negative for shunt, 27 (73%) were positive, and 21 (56.8%) were compatible with IPVD. Patients with and without IPVD showed no differences in age, sex, etiology, severity, or MELD score, independently of the diagnostic test. In the diagnostic validity study (n=37) of CETD versus CEE, the AUC for diagnostic yield was 0.813% (95%CI: 0.666-0.959; P=.001), sensitivity was 76.2% (95%CI: 54.9-89.4) and specificity was 90% (95%CI: 63.9-96.5). The positive likelihood ratio was 6.095. We found a high prevalence of IPVD in candidates for liver transplantation. When a late right-to-left shunt with recirculation is observed, CETD has a high probability of detecting IPVD, with few false-positive results. Because this technique has not previously been described in this indication, similar studies are needed for comparison. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  16. Assessment of peripheral skeletal muscle microperfusion in a porcine model of peripheral arterial stenosis by steady-state contrast-enhanced ultrasound and Doppler flow measurement.

    PubMed

    Naehle, Claas P; Steinberg, Verena A; Schild, Hans; Mommertz, Gottfried

    2015-05-01

    Noninvasive measurement of peripheral muscle microperfusion could potentially improve diagnosis, management, and treatment of peripheral arterial disease (PAD) and thus improve patient care. Contrast-enhanced ultrasound (CEUS) as a noninvasive diagnostic tool allows quantification of muscle perfusion. Increasing data on bolus technique CEUS reflecting microperfusion are becoming available, but only limited data on steady-state CEUS for assessment of muscle microperfusion are available. Therefore, the aim of this study was to evaluate steady-state CEUS for assessment of peripheral muscle microperfusion in a PAD animal model. In a porcine animal model, peripheral muscle microperfusion was quantified by steady-state CEUS replenishment kinetics (mean transit time [mTT] and wash-in rate [WiR]) of the biceps femoris muscle during intravenous steady-state infusion of INN-sulfur hexafluoride (SonoVue; Bracco, Geneva, Switzerland). In addition, macroperfusion was quantified at the external femoral artery with a Doppler flow probe. Peripheral muscle microperfusion and Doppler flow measurements were performed bilaterally at rest and under adenosine stress (70 μg/kg body weight) before and after unilateral creation of a moderate external iliac artery stenosis. All measurements could be performed completely in 10 pigs. Compared with baseline measurements, peripheral muscle microperfusion decreased significantly during adenosine stress (rest vs adenosine stress: mTT, 7.8 ± 3.3 vs 21.2 ± 17.8 s, P = .0006; WiR, 58.4 ± 38.1 vs 25.3 ± 15.6 arbitrary units [a.u.]/s, P < .0001; Doppler flow, 122.3 ± 31.4 vs 83.6 ± 28.1 mL/min, P = .0067) and after stenosis creation (no stenosis vs stenosis: mTT, 8.1 ± 3.1 vs 29.2 ± 18.0 s, P = .0469; WiR, 53.0 ± 22.7 vs 13.6 ± 8.4 a.u./s, P = .0156; Doppler flow, 124.2 ± 41.8 vs 65.9 ± 40.0 mL/min, P = .0313). After stenosis creation, adenosine stress led to a further significant decrease of peripheral muscle microperfusion but had no

  17. Right-to-left shunt detection using contrast-enhanced transcranial Doppler: A comparison of provocation maneuvers between coughing and a modified Valsalva maneuver

    PubMed Central

    Wang, Si-Bo; Wang, Xiao-Cong; Ma, Yan; Liu, Kang-Ding

    2017-01-01

    Contrast-enhanced transcranial Doppler (c-TCD) has been used to detect right-to-left shunts (RLS) because it is highly sensitive and cost-effective. The use of provocation maneuvers, such as physiologic maneuvers (e.g., coughing) and the Valsalva maneuver (VM) to transiently increase right atrial pressure and induce RLS increases the sensitivity of RLS detection. In this study, we sought to determine whether coughing is as effective as the VM in aiding the detection of RLS. We evaluated 162 subjects for RLS, using c-TCD under three different conditions: (i) resting state, (ii) coughing, and (iii) modified VM (m-VM), which involved blowing into a tube connected to a sphygmomanometer at 40 mmHg for 10 s. The positive rate of RLS detection with the m-VM was significantly higher than that with coughing. In addition, a difference between the two maneuvers was observed in terms of the degree of RLS seen. The m-VM should be widely used to detect RLS, because it is reliable, standardized, and cost-effective. PMID:28384297

  18. Hands-Free Transcranial Color Doppler Probe

    NASA Technical Reports Server (NTRS)

    Chin, Robert; Madala, Srihdar; Sattler, Graham

    2012-01-01

    Current transcranial color Doppler (TCD) transducer probes are bulky and difficult to move in tiny increments to search and optimize TCD signals. This invention provides miniature motions of a TCD transducer probe to optimize TCD signals. The mechanical probe uses spherical bearing in guiding and locating the tilting crystal face. The lateral motion of the crystal face as it tilts across the full range of motion was achieved by minimizing the distance between the pivot location and the crystal face. The smallest commonly available metal spherical bearing was used with an outer diameter of 12 mm, a 3-mm tall retaining ring, and 5-mm overall height. Small geared motors were used that would provide sufficient power in a very compact package. After confirming the validity of the basic positioning concept, optimization design loops were completed to yield the final design.

  19. Contrast-enhanced harmonic ultrasonography of medial iliac lymph nodes in healthy dogs.

    PubMed

    Gaschen, Lorrie; Angelette, Nik; Stout, Rhett

    2010-01-01

    Herein, we describe the normal contrast-enhanced harmonic, color, and power Doppler ultrasonographic characteristics of the medial iliac lymph nodes in healthy dogs. Contrast-enhanced harmonic ultrasonography of the medial iliac lymph nodes was performed on 14 healthy dogs after intravenous administration of the lipoprotein-bound inert gas-filled microbubble contrast media Definity. Time-pixel intensity curves were generated for 1-min postinjection. Quantification of these curves was performed using Philips QLab software. Non-contrast-enhanced power and color Doppler examinations were performed in each node to assess vascular patterns subjectively. Normal lymph nodes exhibited a mean contrast wash-in phase beginning at 6.3 s from the time of injection with mean peak pixel intensity at 12.1s. Angioarchitecture was best visualized with contrast-enhanced harmonic ultrasound compared with power and color Doppler. Normal lymph nodes in dogs have a central artery with a centrifugal and uniform branching pattern. Contrast-enhanced harmonic ultrasonography is a noninvasive examination that demonstrates improved visibility of the intranodal architecture of healthy medial iliac lymph nodes in dogs compared with conventional, non-contrast-enhanced Doppler methods that may have future clinical applications.

  20. Hands-Free Transcranial Color Doppler Probe

    NASA Technical Reports Server (NTRS)

    Chin, Robert; Madala, Srihdar; Sattler, Graham

    2012-01-01

    Current transcranial color Doppler (TCD) transducer probes are bulky and difficult to move in tiny increments to search and optimize TCD signals. This invention provides miniature motions of a TCD transducer probe to optimize TCD signals. The mechanical probe uses a spherical bearing in guiding and locating the tilting crystal face. The lateral motion of the crystal face as it tilts across the full range of motion was achieved by minimizing the distance between the pivot location and the crystal face. The smallest commonly available metal spherical bearing was used with an outer diameter of 12 mm, a 3-mm tall retaining ring, and 5-mm overall height. Small geared motors were used that would provide sufficient power in a very compact package. After confirming the validity of the basic positioning concept, optimization design loops were completed to yield the final design. A parallel motor configuration was used to minimize the amount of space wasted inside the probe case while minimizing the overall case dimensions. The distance from the front edge of the crystal to the edge of the case was also minimized to allow positioning of the probe very close to the ear on the temporal lobe. The mechanical probe is able to achieve a +/-20deg tip and tilt with smooth repeatable action in a very compact package. The enclosed probe is about 7 cm long, 4 cm wide, and 1.8 cm tall. The device is compact, hands-free, and can be adjusted via an innovative touchscreen. Positioning of the probe to the head is performed via conventional transducer gels and pillows. This device is amendable to having advanced software, which could intelligently focus and optimize the TCD signal.

  1. Ultrasonography with color Doppler and power Doppler in the diagnosis of periapical lesions

    PubMed Central

    Goel, Sumit; Nagendrareddy, Suma Gundareddy; Raju, Manthena Srinivasa; Krishnojirao, Dayashankara Rao Jingade; Rastogi, Rajul; Mohan, Ravi Prakash Sasankoti; Gupta, Swati

    2011-01-01

    Aim: To evaluate the efficacy of ultrasonography (USG) with color Doppler and power Doppler applications over conventional radiography in the diagnosis of periapical lesions. Materials and Methods: Thirty patients having inflammatory periapical lesions of the maxillary or mandibular anterior teeth and requiring endodontic surgery were selected for inclusion in this study. All patients consented to participate in the study. We used conventional periapical radiographs as well as USG with color Doppler and power Doppler for the diagnosis of these lesions. Their diagnostic performances were compared against histopathologic examination. All data were compared and statistically analyzed. Results: USG examination with color Doppler and power Doppler identified 29 (19 cysts and 10 granulomas) of 30 periapical lesions accurately, with a sensitivity of 100% for cysts and 90.91% for granulomas and a specificity of 90.91% for cysts and 100% for granulomas. In comparison, conventional intraoral radiography identified only 21 lesions (sensitivity of 78.9% for cysts and 45.4% for granulomas and specificity of 45.4% for cysts and 78.9% for granulomas). There was definite correlation between the echotexture of the lesions and the histopathological features except in one case. Conclusions: USG imaging with color Doppler and power Doppler is superior to conventional intraoral radiographic methods for diagnosing the nature of periapical lesions in the anterior jaws. This study reveals the potential of USG examination in the study of other jaw lesions. PMID:22223940

  2. Effects of transducer, velocity, Doppler angle, and instrument settings on the accuracy of color Doppler ultrasound.

    PubMed

    Stewart, S F

    2001-04-01

    The accuracy of a commercial color Doppler ultrasound (US) system was assessed in vitro using a rotating torus phantom. The phantom consisted of a thin rubber tube filled with a blood-mimicking fluid, joined at the ends to form a torus. The torus was mounted on a disk suspended in water, and rotated at constant speeds by a motor. The torus fluid was shown in a previous study to rotate as a solid body, so that the actual fluid velocity was dependent only on the motor speed and sample volume radius. The fluid velocity could, thus, be easily compared to the color Doppler-derived velocity. The effects of instrument settings, velocity and the Doppler angle was assessed in four transducers: a 2.0-MHz phased-array transducer designed for cardiac use, a 4.0-MHz curved-array transducer designed for general thoracic use, and two linear transducers designed for vascular use (one 4.0 MHz and one 6.0 MHz). The color Doppler accuracy was found to be significantly dependent on the transducer used, the pulse-repetition frequency and wall-filter frequency, the actual fluid velocity and the Doppler angle (p < 0.001 by analysis of variance). In particular, the phased array and curved array were observed to be significantly more accurate than the two linear arrays. The torus phantom was found to provide a sensitive measure of color Doppler accuracy. Clinicians need to be aware of these effects when performing color Doppler US exams.

  3. [Doppler color ultrasonography in patients with erectile dysfunction].

    PubMed

    Migaleddu, V; Virgilio, G; Cucciari, P; Retanda, L; Carboni, C; Piras, P; Carboni, M; Canalis, G C

    2000-12-01

    The introduction of new oral therapy doesn't change the rule of color Doppler US in the screening modality of the diagnosis of vasculogenic impotence. The hemodynamic changes can be non invasively evaluated with color and energy Doppler US and with spectral analysis following injection of a vaso-active pharmacological agent. The new high sensitive US equipment allows an easy detection of the cavernous artery. Duplex Doppler can quantify the systolic-diastolic flow changes after the intra-cavernous vaso-active drugs injection. It is then possible to establish the diagnosis of arterial or venous vasculogenic impotence. The organic cause can also be excluded. The pick systolic velocity less than 0.30 m/sec is indicative of arterial origin. The absence of flow-reversal in the diastolic phase, 30 minutes after the injection, is significant for a venous type problem. Elicine arteries can be visualised and analysed using high sensitive color Doppler energy US equipment.

  4. Aliasing-tolerant color Doppler quantification of regurgitant jets.

    PubMed

    Stewart, S F

    1998-07-01

    Conservation of momentum transfer in regurgitant cardiac jets can be used to calculate the flow rate from color Doppler velocities. In this study, turbulent jets were simulated by finite elements; pseudocolor Doppler images were interpolated from the computations, with aliasing introduced artificially. Jets were also imaged by color Doppler in an in vitro flow system. To suppress aliasing errors, jet velocities were fitted iteratively to a fluid mechanical model constrained to match the orifice velocity (measured without aliasing by continuous-wave Doppler). At each iteration, the model was used to detect aliased velocities, which were excluded during the next iteration. Iteration continued until the flow rate calculated by the model and number of calculated nonaliased pixels were unchanged. The good correlations between measured and calculated flow rates in the experimental (R2 = 0.933) and computational studies (R2 = 0.990) suggest that this may be a clinically useful approach even in aliased images. Published by Elsevier Science Inc.

  5. Color duplex ultrasound and contrast-enhanced ultrasound in comparison to MS-CT in the detection of endoleak following endovascular aneurysm repair.

    PubMed

    Clevert, D-A; Minaifar, N; Weckbach, S; Kopp, R; Meimarakis, G; Clevert, D-A; Reiser, M

    2008-01-01

    The purpose of this study was to compare Color Duplex Ultrasound (CDU), Contrast-Enhanced Ultrasound (CEUS) and Multislice Computed Tomography (MS-CT) angiography in the routine follow up of patients following Endovascular Repair (EVAR) of Abdominal Aortic Aneurysm (AAA).43 consecutive patients with AAA underwent endovascular aneurysm repair and were imaged with CDU, CEUS and MS-CT angiography at regular intervals after the procedure. Each imaging modality was evaluated for the detection of endoleaks. The presence of endoleaks was analyzed and the conspicuity of findings was assessed.CTA was used as gold standard in determining the presence of endoleaks. CDU was true positive for endoleaks in 5/43 patients (11.6%) and false positive for endoleaks in 2/43 patients (4.6%). The sensitivity of CDU was therefore 33.3% and its specificity 92.8%; the positive and negative predictive values were 0.71 and 0.72, respectively. CEUS was true positive for the detection of endoleaks in 15/43 patients (34.9%) and false positive in 2/43 patients (4.6%). The sensitivity of CEUS was therefore 100% and its specificity 93%; the positive and negative predictive values were 0.88 and 1. In the follow up the two false positive endoleaks in CEUS were confirmed as true positive endoleaks by CEUS and MS-CT. In our small patient group, contrast-enhanced ultrasound seemed to be more accurately in demonstrating endoleaks after EVAR than MS-CT angiography and may be considered as a primary surveillance modality whereas duplex ultrasound scanning alone is not as sensitive as CEUS and MS-CT angiography in detection of endoleaks. Especially in patients with contraindications for CT contrast agents (e.g. due to renal failure or severe allergy) CEUS provides a good alternative to MS-CT.

  6. Temporal enhancement of two-dimensional color doppler echocardiography

    NASA Astrophysics Data System (ADS)

    Terentjev, Alexey B.; Settlemier, Scott H.; Perrin, Douglas P.; del Nido, Pedro J.; Shturts, Igor V.; Vasilyev, Nikolay V.

    2016-03-01

    Two-dimensional color Doppler echocardiography is widely used for assessing blood flow inside the heart and blood vessels. Currently, frame acquisition time for this method varies from tens to hundreds of milliseconds, depending on Doppler sector parameters. This leads to low frame rates of resulting video sequences equal to tens of Hz, which is insufficient for some diagnostic purposes, especially in pediatrics. In this paper, we present a new approach for reconstruction of 2D color Doppler cardiac images, which results in the frame rate being increased to hundreds of Hz. This approach relies on a modified method of frame reordering originally applied to real-time 3D echocardiography. There are no previous publications describing application of this method to 2D Color Doppler data. The approach has been tested on several in-vivo cardiac 2D color Doppler datasets with approximate duration of 30 sec and native frame rate of 15 Hz. The resulting image sequences had equivalent frame rates to 500Hz.

  7. Grayscale and Color Doppler Features of Testicular Lymphoma

    PubMed Central

    Bertolotto, Michele; Derchi, Lorenzo E.; Secil, Mustafa; Dogra, Vikram; Sidhu, Paul S.; Clements, Richard; Freeman, Simon; Grenier, Nicolas; Mannelli, Lorenzo; Ramchandani, Parvati; Cicero, Calogero; Abete, Luca; Bussani, Rossana; Rocher, Laurence; Spencer, John; Tsili, Athina; Valentino, Massimo; Pavlica, Pietro

    2016-01-01

    Pooled data from 16 radiology centers were retrospectively analyzed to seek patients with pathologically proven testicular lymphoma and grayscale and color Doppler images available for review. Forty-three cases were found: 36 (84%) primary and 7 (16%) secondary testicular lymphoma. With unilateral primary lymphoma, involvement was unifocal (n = 10), multifocal (n = 11), or diffuse (n = 11). Synchronous bilateral involvement occurred in 6 patients. Color Doppler sonography showed normal testicular vessels within the tumor in 31 of 43 lymphomas (72%). Testicular lymphoma infiltrates through the tubules, preserving the normal vascular architecture of the testis. Depiction of normal testicular vessels crossing the lesion is a useful adjunctive diagnostic criterion. PMID:26014335

  8. Color Doppler imaging of cardiac catheters using vibrating motors.

    PubMed

    Reddy, Kalyan E; Light, Edward D; Rivera, Danny J; Kisslo, Joseph A; Smith, Stephen W

    2008-10-01

    A miniature motor rotating at 11,000 rpm was attached onto the proximal end of cardiac electrophysiological (EP) catheters in order to produce vibrations at the tip that were then visualized by color Doppler on ultrasound scanners. The catheter tip was imaged within a vascular graft submerged in a water tank using the Volumetrics Medical Imaging 3D scanner, the Siemens Sonoline Antares 2D scanner and the Philips ie33 3D ultrasound scanner with TEE probe. The vibrating catheter tip was visualized in each case, although results varied with the color Doppler properties of the individual scanner.

  9. Color Doppler Imaging of Cardiac Catheters Using Vibrating Motors

    PubMed Central

    Reddy, Kalyan E.; Light, Edward D.; Rivera, Danny J.; Kisslo, Joseph A.; Smith, Stephen W.

    2010-01-01

    We attached a miniature motor rotating at 11,000 rpm onto the proximal end of cardiac electrophysiological (EP) catheters in order to produce vibrations at the tip which were then visualized by color Doppler on ultrasound scanners. We imaged the catheter tip within a vascular graft submerged in a water tank using the Volumetrics Medical Imaging 3D scanner, the Siemens Sonoline Antares 2D scanner, and the Philips ie33 3D ultrasound scanner with TEE probe. The vibrating catheter tip was visualized in each case though results varied with the color Doppler properties of the individual scanner. PMID:19514134

  10. Doppler vortography: a color Doppler approach for quantification of the intraventricular blood flow vortices

    PubMed Central

    Mehregan, Forough; Tournoux, François; Muth, Stéphan; Pibarot, Philippe; Rieu, Régis; Cloutier, Guy; Garcia, Damien

    2013-01-01

    We propose a new approach for quantification of intracardiac vorticity – Doppler vortography – based on conventional color Doppler images. Doppler vortography relies on the centrosymmetric properties of the vortices. Such properties induce particular symmetries in the Doppler flow data which can be exploited to describe the vortices quantitatively. For this purpose, a kernel filter was developed to derive a parameter –the blood vortex signature (BVS) – that allows detecting the main intracardiac vortices and estimating their core vorticities. The reliability of Doppler vortography was assessed in mock Doppler fields issued from simulations and in vitro data. Doppler vortography was also tested in patients and compared with vector flow mapping by echocardiography. Strong correlations were obtained between the Doppler vortography-derived and the ground-truth vorticities (in silico: r2 = 0.98, in vitro: r2 = 0.86, in vivo: r2 = 0.89). Our results demonstrated that Doppler vortography is a potentially promising echocardiographic tool for quantification of vortex flow in the left ventricle. PMID:24210865

  11. [Color Doppler in breast tumor pathology].

    PubMed

    Balu-Maestro, C; Bruneton, J N; Giudicelli, T; Chauvel, C; Hery, M D

    1991-11-01

    Colour Doppler findings in a series of 63 cases of breast tumours and 19 cases of lymph node enlargements are reported. Colour Doppler signals of abnormal flow are found in 68.5 percent of the cancers, in 42.8 percent of metastatic lymph nodes and in 10 percent of benign lesions. There was bidirectional flow in 80 percent of all the cases. In cases of malignant tumours, the signal was correlated with the size and location of the lesions most often found peripherally. Presently, this technique appears to be of little value in determining whether a primary malignant tumour of the breast is malignant or benign. It does appear to be useful, first to follow-up cancers during initial chemotherapy (partial regression of the signal and of tumour volume) and secondly, in the diagnosis of metastatic lymph nodes with a specificity of 100 percent in our series. Colour Doppler is on the contrary difficult to interprete after conservative treatment of breast cancer because of post-radiotherapy tissue remodelling.

  12. A rotating torus phantom for assessing color Doppler accuracy.

    PubMed

    Stewart, S F

    1999-10-01

    A rotating torus phantom was designed to assess the accuracy of color Doppler ultrasound. A thin rubber tube was filled with blood analog fluid and joined at the ends to form a torus, then mounted on a disk submerged in water and rotated at constant speeds by a motor. Flow visualization experiments and finite element analyses demonstrated that the fluid accelerates quickly to the speed of the torus and spins as a solid body. The actual fluid velocity was found to be dependent only on the motor speed and location of the sample volume. The phantom was used to assess the accuracy of Doppler-derived velocities during two-dimensional (2-D) color imaging using a commercial ultrasound system. The Doppler-derived velocities averaged 0.81 +/- 0.11 of the imposed velocity, with the variations significantly dependent on velocity, pulse-repetition frequency and wall filter frequency (p < 0.001). The torus phantom was found to have certain advantages over currently available Doppler accuracy phantoms: 1. It has a high maximum velocity; 2. it has low velocity gradients, simplifying the calibration of 2-D color Doppler; and 3. it uses a real moving fluid that gives a realistic backscatter signal.

  13. [Ultrasound and color Doppler imaging for kidney and urinary tract tumors].

    PubMed

    Meola, Mario; Petrucci, Ilaria; Giovannini, Lisa; Colombini, Elisa; Villa, Adriana

    2012-01-01

    When a renal mass is suspected, conventional ultrasound and color Doppler imaging are often used for initial assessment. Ultrasound screening has many advantages over contrast-enhanced CT and MRI, such as accessibility, low costs, and no need for intravenous iodine contrast administration or ionizing radiation. Sonography is very helpful to distinguish cystic from solid lesions and to monitor the growth and structural pattern of cysts. Detection of small renal carcinoma of less than 3 cm in diameter is limited, however, and small tumors are detected by conventional ultrasound only in 67-79% of cases. In fact, small renal malignancies may have an echogenicity similar to the normal renal parenchyma. In these cases it is very hard to distinguish the tumor, particularly when there is no evident disarrangement of the normal renal contours and no extension into the central renal complex. Renal cell carcinoma can also be hypo- or hyperechoic and indistinguishable from renal adenoma/oncocytoma or angiomyolipomas, which are commonly described as hyperechoic masses. In other words, the pattern and ultrasound characteristics of renal masses often overlap between benign and malignant tumors. A diagnosis of a malignant cystic lesion requires evidence of multiple, thickened internal septa, calcifications, vascularity, and parietal nodularity. When a solid lesion does not show the typical appearance of a simple cyst (a round anechoic lesion with a smooth well-defined wall, without internal debris, and showing increased through-transmission), further evaluation with contrast-enhanced CT or MRI is necessary. Contrast-enhanced ultrasound (CEUS) improves the sensitivity for detection of small renal masses. Compared to CT, CEUS is able to better visualize the number of septa, the septum and wall thickness, the presence of a solid component, and enhancement in some cases, resulting in upgrading of the Bosniak classification and affecting treatment planning.

  14. Ultrasonography and color Doppler of proximal gluteal enthesitis in juvenile idiopathic arthritis: a descriptive study

    PubMed Central

    2011-01-01

    Background The presence of enthesitis (insertional inflammation) in patients with juvenile idiopathic arthritis (JIA) is difficult to establish clinically and may influence classification and treatment of the disease. We used ultrasonography (US) and color Doppler (CD) imaging to detect enthesitis at the small and deep-seated proximal insertion of the gluteus medius fascia on the posterior iliac crest where clinical diagnosis is difficult. The findings in JIA patients were compared with those obtained in healthy controls and with the patients' MRI results. Methods Seventy-six proximal gluteus medius insertions were studied clinically (tenderness to palpation of the posterior iliac crest) and by US and CD (echogenicity, thickness, hyperemia) in 38 patients with JIA and in 38 healthy controls, respectively (median age 13 years, range 7-18 years). In addition, an additional MRI examination of the sacroiliac joints and iliac crests was performed in all patients. Results In patients with focal, palpable tenderness, US detected decreased echogenicity of the entheses in 53% of the iliac crests (bilateral in 37% and unilateral in 32%). US also revealed significantly thicker entheses in JIA patients compared to healthy controls (p < 0.003 left side, p < 0.001 right side). There was no significant difference in thickness between the left and right sides in individual subjects. Hyperemia was detected by CD in 37% (28/76) of the iliac crests and by contrast-enhanced MRI in 12% (6/50). Conclusions According to US, the gluteus medius insertion was thicker in JIA patients than in controls, and it was hypoechoic (enthesitis) in about half of the patients. These findings may represent chronic, inactive disease in some of the patients, because there was only limited Doppler flow and MRI contrast enhancement. The present study indicates that US can be useful as an adjunct to clinical examination for improved assessment of enthesitis in JIA. This may influence disease classification

  15. Color Doppler imaging in glaucoma patients with asymmetric optic cups.

    PubMed

    Costa, V P; Sergott, R C; Smith, M; Spaeth, G L; Wilson, R P; Moster, M R; Katz, L J; Schmidt, C M

    1994-01-01

    To evaluate the color Doppler imaging (CDI) parameters of the retrobulbar circulation, we performed color Doppler imaging in both eyes of 29 glaucomatous patients with asymmetric cups [asymmetry >0.3 cup/disc ratio (C/D)] and asymmetric visual field loss. We used the QAD-1 Color Doppler unit (Quantum Medical Systems Inc.) with a 7.5-MHz linear-phased transducer to calculate the pulsatility index, and the peak systolic, end diastolic, and average blood-flow velocities in the ophthalmic, central retinal, nasal, and temporal short posterior ciliary arteries of each eye. In a second analysis, we compared the results of a randomly selected eye of age- and sex-matched controls. Paired t tests did not show any significant difference between the blood-flow velocities of the more damaged and less damaged eyes when the entire 29-patient group was considered together. The power was adequate to detect a 1.0 cm/s difference in most of the analyzed vessels. Thirteen of the 29 patients had primary open-angle glaucoma (POAG), and the remaining eyes had pseudoexfoliation and low tension, pigmentary, and chronic angle-closure glaucoma. When compared to age- and sex-matched controls, the less damaged eyes of patients with POAG displayed reduced systolic, diastolic, and mean velocities (p < 0.05) in the ophthalmic artery. In comparison, the more damaged eyes revealed statistically reduced velocities in the ophthalmic artery, temporal short posterior ciliary artery, and in all the parameters for the mean values of the short posterior ciliary arteries (p < 0.05). More advanced optic nerve damage in patients with POAG correlated with more severe reductions of CDI parameters of the retrobulbar circulation of patients with asymmetric disease. Further clinical color Doppler correlations are now mandatory to determine whether these vascular changes are pathogenetically important or epiphenomena.

  16. Color-flow Doppler sonography in Graves disease: "thyroid inferno".

    PubMed

    Ralls, P W; Mayekawa, D S; Lee, K P; Colletti, P M; Radin, D R; Boswell, W D; Halls, J M

    1988-04-01

    Graves disease is a common diffuse abnormality of the thyroid gland usually characterized by thyrotoxicosis. We performed color-flow Doppler sonography in 16 patients with Graves disease and compared the results with those in 15 normal volunteers and 14 patients with other thyroid diseases (eight with multinodular goiter, four with focal masses, and two with papillary thyroid carcinoma). All 16 Graves disease patients exhibited a pulsatile pattern we call "thyroid inferno." This pattern consists of multiple small areas of intrathyroidal flow seen diffusely throughout the gland in both systole and diastole. In systole, both high-velocity flow (color coded white) and lower velocity flow (color coded red and blue) were noted. In diastole, fewer areas of flow and lower velocity flow were noted. Patients with Graves disease also exhibited color flow around the periphery of the gland. The inferno pattern did not occur in normal subjects or in patients with other thyroid diseases. On occasion, focal areas of intrathyroidal flow were detected in patients with multinodular goiter and focal thyroid masses. High-resolution gray-scale images did not show the small vascular channels from which the flow signal originated. Color-flow Doppler sonography shows promise as a cost-effective, noninvasive technique for diagnosing Graves disease.

  17. Retained products of conception: spectrum of color Doppler findings.

    PubMed

    Kamaya, Aya; Petrovitch, Ivan; Chen, Bertha; Frederick, Carrie E; Jeffrey, R Brooke

    2009-08-01

    The purpose of this study was to characterize color Doppler imaging features of retained products of conception (RPOC) with gray scale correlation. Clinically suspected cases of RPOC between January 2005 and February 2008 were reviewed. Patient data and relevant color Doppler and gray scale features were recorded. A total of 269 patients referred for sonographic evaluation for RPOC were identified. Thirty-five patients had confirmed pathologic diagnoses, 28 of whom had RPOC. In those with RPOC, 5 (18%) were avascular (type 0); 6 (21%) had minimal vascularity (type 1); 12 (43%) had moderate vascularity (type 2); and 5 (18%) had marked vascularity (type 3). Peak systolic velocities ranged from 10 to 108 cm/s (average, 36.1 cm/s). Resistive indices in arterial waveforms ranged from 0.33 to 0.7 (average, 0.5). Five (45%) of the patients with type 0 vascularity had RPOC; 6 (86%) of those with type 1 had RPOC; and 17 (100%) of those with types 2 and 3 had RPOC. An echogenic mass had a moderate positive predictive value (80%) but low sensitivity (29%) for RPOC. Color Doppler evaluation of the endometrium is helpful in determining the presence of RPOC. Endometrial vascularity is highly correlated with RPOC, whereas the lack of vascularity can be seen in both intrauterine clots and avascular RPOC.

  18. Adaptive clutter rejection for ultrasound color Doppler imaging

    NASA Astrophysics Data System (ADS)

    Yoo, Yang Mo; Managuli, Ravi; Kim, Yongmin

    2005-04-01

    We have developed a new adaptive clutter rejection technique where an optimum clutter filter is dynamically selected according to the varying clutter characteristics in ultrasound color Doppler imaging. The selection criteria have been established based on the underlying clutter characteristics (i.e., the maximum instantaneous clutter velocity and the clutter power) and the properties of various candidate clutter filters (e.g., projection-initialized infinite impulse response and polynomial regression). We obtained an average improvement of 3.97 dB and 3.27 dB in flow signal-to-clutter-ratio (SCR) compared to the conventional and down-mixing methods, respectively. These preliminary results indicate that the proposed adaptive clutter rejection method could improve the sensitivity and accuracy in flow velocity estimation for ultrasound color Doppler imaging. For a 192 x 256 color Doppler image with an ensemble size of 10, the proposed method takes only 57.2 ms, which is less than the acquisition time. Thus, the proposed method could be implemented in modern ultrasound systems, while providing improved clutter rejection and more accurate velocity estimation in real time.

  19. Sevoflurane Used for Color Doppler Ultrasound Examination in Children.

    PubMed

    Fan, Conghai; Zhang, Fengchao; Huang, Xiaomei; Wen, Cheng; Shan, Chengjing

    2015-05-01

    The objective of this study is to investigate the feasibility of sevoflurane inhalation in pediatric color doppler ultrasound examination. In this study, 30 cases of children under 1 year were selected. They were all I or II levels according to American Society of Anesthesiology. Children with severe cyanotic congenital heart disease or severe pneumonia were excluded. All the children received anesthesia with sevoflurane. The University of Michigan Sedation Scale was assessed and bispectral index (BIS) was recorded before induction (T0), after induction (T1), when maintaining (T2), and when waking-up (T3). Blood pressure and heart rate were monitored during the color doppler ultrasound examination, the time to receive sedation examination and anesthesia recovery time were also recorded. (1) Score for UMSS was zero at T0 and 3 at T1; (2) BIS value was 93.18 ± 2.94 at T0 and decreased to 87.6 ± 3.9 at T1; (3) Blood pressure or heart rate did not decline obviously; (4) The time to receive sedation examination was 46.4 ± 13.1 s and anesthesia recovery time was 7.8 ± 5.3 min. In conclusion, sevoflurane can be used in pediatric color doppler ultrasound examination safely and effectively.

  20. Effect of Peripheral Artery Sympathetic Denervation on Muscle Microperfusion and Macroperfusion in an Animal Peripheral Artery Disease Model Using Contrast-Enhanced Ultrasound and Doppler Flow Measurement.

    PubMed

    Steinberg, Verena A; Mommertz, Gottfried; Thiesler, Thore; Kristiansen, Glen; Schild, Hans; Naehle, Claas P

    2015-09-01

    To determine the effects of catheter-based peripheral sympathetic denervation (CPSD) on peripheral artery sympathetic tone and peripheral microperfusion (PMP). The effects of bilateral CPSD in common iliac arteries on PMP of the biceps femoris were determined in pigs using contrast-enhanced ultrasound, and mean transit time (mTT) and wash-in rate (WiR) were calculated during steady-state infusion of INN-sulfur-hexafluoride. Measurements were performed bilaterally at rest and during infusion of adenosine 70 μg/kg/min after unilateral moderate left external iliac artery stenosis. Before CPSD, PMP decreased significantly (P < .05) under adenosine stress compared with resting conditions, with right mTT of 7.5 seconds ± 3.6 versus 16.9 seconds ± 11.9 and WiR of 63.1 arbitrary units (AU) ± 49.0 versus 25.0 AU ± 17.5 and left mTT of 29.2 seconds ± 18.0 versus 56.3 seconds ± 38.7 and WiR of 13.6 AU ± 8.4 versus 6.0 AU ± 4.1. After CPSD, PMP did not differ significantly (P > .05) between conditions of adenosine stress and rest, with right mTT of 19.9 seconds ± 24.7 versus 23.2 seconds ± 21.0 and WiR of 16.2 AU ± 25.0 versus 20.5 AU ± 19.7 and left mTT of 23.3 seconds ± 23.1 versus 25.8 seconds ± 21.7 and WiR of 12.5 AU ± 6.2 versus 20.0 AU ± 12.1. CPSD reduced peripheral artery sympathetic tone and may be an alternative to surgical or computed tomography-guided sympathectomy for the treatment of end-stage peripheral artery disease and Raynaud phenomenon. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

  1. Real-time high-velocity resolution color Doppler OCT

    NASA Astrophysics Data System (ADS)

    Westphal, Volker; Yazdanfar, Siavash; Rollins, Andrew M.; Izatt, Joseph A.

    2001-05-01

    Color Doppler optical coherence tomography (CDOCT), also called Optical Doppler Tomography) is a noninvasive optical imaging technique, which allows for micron-scale physiological flow mapping simultaneous with morphological OCT imaging. Current systems for real-time endoscopic optical coherence tomography (EOCT) would be enhanced by the capability to visualize sub-surface blood flow for applications in early cancer diagnosis and the management of bleeding ulcers. Unfortunately, previous implementations of CDOCT have either been sufficiently computationally expensive (employing Fourier or Hilbert transform techniques) to rule out real-time imaging of flow, or have been restricted to imaging of excessively high flow velocities when used in real time. We have developed a novel Doppler OCT signal-processing strategy capable of imaging physiological flow rates in real time. This strategy employs cross-correlation processing of sequential A-scans in an EOCT image, as opposed to autocorrelation processing as described previously. To measure Doppler shifts in the kHz range using this technique, it was necessary to stabilize the EOCT interferometer center frequency, eliminate parasitic phase noise, and to construct a digital cross correlation unit able to correlate signals of megahertz bandwidth by a fixed lag of up to a few ms. The performance of the color Doppler OCT system was demonstrated in a flow phantom, demonstrating a minimum detectable flow velocity of ~0.8 mm/s at a data acquisition rate of 8 images/second (with 480 A-scans/image) using a handheld probe. Dynamic flow as well as using it freehanded was shown. Flow was also detectable in a phantom in combination with a clinical usable endoscopic probe.

  2. Assessment of changes in vascularity and blood volume in canine sarcomas and squamous cell carcinomas during fractionated radiation therapy using quantified contrast-enhanced power Doppler ultrasonography: a preliminary study.

    PubMed

    Ohlerth, Stefanie; Bley, Carla Rohrer; Laluhová, Dagmar; Roos, Malgorzata; Kaser-Hotz, Barbara

    2010-10-01

    Radiation therapy does not only target tumour cells but also affects tumour vascularity. In the present study, changes in tumour vascularity and blood volume were investigated in five grade 1 oral fibrosarcomas, eight other sarcomas (non-oral soft tissue and bone sarcomas) and 12 squamous cell carcinomas in dogs during fractionated radiation therapy (total dose, 45-56 Gy). Contrast-enhanced power Doppler ultrasound was performed before fraction 1, 3, 6, 8, 10, 12, 14 and 15 or 16 (sarcomas) or 17 (squamous cell carcinomas). Prior to treatment, median vascularity and blood volume were significantly higher in squamous cell carcinomas (P=0.0005 and 0.001), whereas measurements did not differ between oral fibrosarcomas and other sarcomas (P=0.88 and 0.999). During the course of radiation therapy, only small, non-significant changes in vascularity and blood volume were observed in all three tumour histology groups (P=0.08 and P=0.213), whereas median tumour volume significantly decreased until the end of treatment (P=0.04 for fibrosarcomas and other sarcomas, P=0.008 for squamous cell carcinomas). It appeared that there was a proportional decrease in tumour volume, vascularity and blood volume. Doppler measurements did not predict progression free interval or survival in any of the three tumour groups (P=0.06-0.86). However, the number of tumours investigated was small and therefore, the results can only be considered preliminary.

  3. Prototype vein contrast enhancer

    NASA Astrophysics Data System (ADS)

    Zeman, Herbert D.; Lovhoiden, Gunnar; Vrancken, Carlos

    2004-07-01

    A proof-of-principle prototype Vein Contrast Enhancer (VCE) has been designed and constructed. The VCE is an instrument that makes vein access easier by capturing an infrared image of peripheral veins, enhancing the vein-contrast using software image processing, and projecting the enhanced vein-image back onto the skin using a modified commercial projector. The prototype uses software alignment to achieve alignment accuracy between the captured infrared image and the projected visible image of better than 0.06 mm. Figure 1 shows the prototype demonstrated in our laboratory.

  4. Role of Ultrasound with Color Doppler in Acute Scrotum Management

    PubMed Central

    Agrawal, Alka M.; Tripathi, Prem Siddharth; Shankhwar, Amit; Naveen, C.

    2014-01-01

    Background and Objective: An acute scrotum is defined as acute pain with or without scrotal swelling, may be accompanied by local signs or general symptoms. Acute scrotal pain is a medical emergency. Depending on cause, the management is entirely different. Torsion of testis and strangulated hernia are surgical emergency; whereas, epididymo-orchitis is treated by medicines. Testicular trauma and obstructed hernia can be differentiated by taking history from patient. Physical examination adds only a little information. Color Doppler ultrasound (US) is the modality of choice to differentiate testicular torsion from inflammatory conditions and can thus help in avoiding unnecessary surgical explorations. Subjects and Methods: A study on 50 patients was conducted who were referred with history of acute scrotal pain to our department between January 2013 and January 2014. Trauma and scrotal mass were excluded from the study. The clinical presentation, outcome, and US results were analyzed. Results: Color Doppler sonography yielded a positive and negative predictive value (PPV and NPV) of 100% each for torsion, whereas, 93.9 and 70.6% for epididymo-orchitis, respectively; a sensitivity and specificity of 100% for torsion, whereas, for epididymo-orchitis it was found to be 86.1 and 85.7%, respectively. In cases of incomplete or early torsion, some residual perfusion may be detected leading to false-negative results. Conclusion: We therefore conclude that color Doppler sonography can reliably rule out testicular torsion and can thus help in avoiding unnecessary surgical explorations. Hence, it can significantly improve outcome and decrease morbidity of patient. It is an accurate, rapid, nonexpensive, nonionizing, important adjunct to clinical assessment of scrotum. PMID:25657954

  5. Two-color dual-beam backscatter laser Doppler velocimeter

    NASA Technical Reports Server (NTRS)

    Grant, G. R.; Orloff, K. L.

    1973-01-01

    A laser Doppler velocimeter has been developed that uses two of the colors emitted from an argon-ion laser for the simultaneous measurement of orthogonal velocities. Designed for use in a 2.13- by 3.05-m wind tunnel, it is capable of traversing its focal volume across spatially unstable flows at scan speeds of up to 1.5 m/sec. Its optical layout and principles of operation are discussed, and the data from a typical traversal of a trailing wing-tip vortex are presented.

  6. A two color, dual beam backscattering laser Doppler velocimeter

    NASA Technical Reports Server (NTRS)

    Grant, G. R.; Orloff, K. L.

    1973-01-01

    A laser Doppler velocimeter has been developed which uses two of the colors emitted from an argon ion laser for the simultaneous measurement of orthogonal velocities. Designed for use in a 2.13 m by 3.05 m wind tunnel, it is capable of traversing its focal volume across spatially unstable flows at scan speeds of up to 1.15 m/sec. Its optical layout and principles of operation are discussed and the data from a typical traversal of a trailing wing tip vortex are presented.

  7. [Color Doppler ultrasound of the scalp and hair].

    PubMed

    Wortsman, X; Roustan, G; Martorell, A

    2015-11-01

    Color Doppler ultrasound is an imaging technique that allows the study of frequent diseases of the scalp and hair. This examination provides anatomical and functional information in real time that can reveal the extent, activity or severity of common diseases in a non-invasive way, and allows monitoring of their treatment. Copyright © 2015 Academia Española de Dermatología y Venereología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Acute segmental testicular infarction at contrast-enhanced ultrasound: early features and changes during follow-up.

    PubMed

    Bertolotto, Michele; Derchi, Lorenzo E; Sidhu, Paul S; Serafini, Giovanni; Valentino, Massimo; Grenier, Nicolas; Cova, Maria A

    2011-04-01

    The purpose of this retrospective study was to assess whether contrast-enhanced ultrasound is useful for characterization of acute segmental testicular infarction. Twenty men with acute scrotal pain and suspected segmental testicular infarction underwent contrast-enhanced ultrasound. Three patients underwent orchiectomy. For the other patients, the final diagnosis was based on the absence of tumor markers and a change in the size or shape of the tumor during follow-up. Forty-nine color Doppler ultrasound studies (16 within 24 hours of the onset of pain; 14, 2-17 days after pain onset; 19 after 1 month or more), and 38 contrast-enhanced ultrasound studies (13 within 24 hours after pain onset; nine, 2-17 days; 16 after 1 month or more) were performed. Fourteen of 16 lesions examined within 24 hours were oval, and two were wedge shaped. Eight lesions were isoechoic to the testis, six were hypoechoic, and two had mixed echogenicity. Twelve lesions were avascular and four were hypovascular at color Doppler examination. Contrast-enhanced ultrasound showed avascular parenchymal lobules in all cases and without perilesional rim enhancement in 12 of 13 studies. Two to 17 days after the symptoms appeared, contrast-enhanced ultrasound showed avascular lobules in all cases and perilesional rim enhancement in eight examinations. After 1 month or more, contrast-enhanced ultrasound depicted intralesional vascular spots in 12 of 14 infarcts. Perilesional enhancement was absent. Recognition of lobular morphologic characteristics and the presence of perilesional rim enhancement at contrast-enhanced ultrasound can increase confidence in the diagnosis of segmental testicular infarction compared with reliance on gray-scale and color Doppler findings. Changes in lesion features during follow-up confirm the differential diagnosis from other testicular lesions and allow conservative management.

  9. Digital storage and analysis of color Doppler echocardiograms

    NASA Technical Reports Server (NTRS)

    Chandra, S.; Thomas, J. D.

    1997-01-01

    Color Doppler flow mapping has played an important role in clinical echocardiography. Most of the clinical work, however, has been primarily qualitative. Although qualitative information is very valuable, there is considerable quantitative information stored within the velocity map that has not been extensively exploited so far. Recently, many researchers have shown interest in using the encoded velocities to address the clinical problems such as quantification of valvular regurgitation, calculation of cardiac output, and characterization of ventricular filling. In this article, we review some basic physics and engineering aspects of color Doppler echocardiography, as well as drawbacks of trying to retrieve velocities from video tape data. Digital storage, which plays a critical role in performing quantitative analysis, is discussed in some detail with special attention to velocity encoding in DICOM 3.0 (medical image storage standard) and the use of digital compression. Lossy compression can considerably reduce file size with minimal loss of information (mostly redundant); this is critical for digital storage because of the enormous amount of data generated (a 10 minute study could require 18 Gigabytes of storage capacity). Lossy JPEG compression and its impact on quantitative analysis has been studied, showing that images compressed at 27:1 using the JPEG algorithm compares favorably with directly digitized video images, the current goldstandard. Some potential applications of these velocities in analyzing the proximal convergence zones, mitral inflow, and some areas of future development are also discussed in the article.

  10. Color Doppler imaging of untreated and irradiated choroidal melanomas.

    PubMed

    Regan, S; Egan, K M; Hart, L; Gragoudas, E S

    2001-01-01

    We examined untreated and irradiated choroidal melanomas with color Doppler imaging (CDI), a noninvasive method providing quantitative measures of blood flow, to determine if the tumor vessel damage associated with irradiation can be detected using this technology. CDI was performed on 122 untreated and 76 previously irradiated tumors using a Q2000 color Doppler ultrasound unit. Spectral analysis was performed on all detectable vascular regions within the tumor to obtain estimates of the peak systolic and end diastolic flow velocities and resistive index ((syst-diast)/syst). Vessels were detected in 93% of the untreated tumors and in 63% of the treated tumors (p<0.001, X2), and the median number of vascular regions found was higher among untreated tumors (3 vs 1, p=0.001, Wilcoxon Rank Sum). The effect of treatment status on the detection of tumor vessels was significant (p=0.039), controlling for age, sex, largest tumor pretreatment diameter, and tumor height at CDI in a logistic regression model. Mean resistive index was lower in the untreated tumors (0.53 vs 0.58, p=0.0050), controlling for tumor height and other covariates in an analysis of variance. On examination with CDI, irradiated tumors had fewer detectable vascular regions and greater resistance to flow than untreated tumors, a pattern consistent with known radiation effects.

  11. Digital storage and analysis of color Doppler echocardiograms

    NASA Technical Reports Server (NTRS)

    Chandra, S.; Thomas, J. D.

    1997-01-01

    Color Doppler flow mapping has played an important role in clinical echocardiography. Most of the clinical work, however, has been primarily qualitative. Although qualitative information is very valuable, there is considerable quantitative information stored within the velocity map that has not been extensively exploited so far. Recently, many researchers have shown interest in using the encoded velocities to address the clinical problems such as quantification of valvular regurgitation, calculation of cardiac output, and characterization of ventricular filling. In this article, we review some basic physics and engineering aspects of color Doppler echocardiography, as well as drawbacks of trying to retrieve velocities from video tape data. Digital storage, which plays a critical role in performing quantitative analysis, is discussed in some detail with special attention to velocity encoding in DICOM 3.0 (medical image storage standard) and the use of digital compression. Lossy compression can considerably reduce file size with minimal loss of information (mostly redundant); this is critical for digital storage because of the enormous amount of data generated (a 10 minute study could require 18 Gigabytes of storage capacity). Lossy JPEG compression and its impact on quantitative analysis has been studied, showing that images compressed at 27:1 using the JPEG algorithm compares favorably with directly digitized video images, the current goldstandard. Some potential applications of these velocities in analyzing the proximal convergence zones, mitral inflow, and some areas of future development are also discussed in the article.

  12. Conventional color Doppler velocity sonography versus color Doppler energy sonography for the diagnosis of acute experimental torsion of the spermatic cord.

    PubMed

    Lee, F T; Winter, D B; Madsen, F A; Zagzebski, J A; Pozniak, M A; Chosy, S G; Scanlan, K A

    1996-09-01

    We compared color Doppler velocity sonography and color Doppler energy sonography for the diagnosis of spermatic cord torsion in a canine model and determined the degree of torsion necessary to acutely halt testicular blood flow. Spermatic cord torsion was created in five dogs by exposing and rotating the ipsilateral testis 0 degree, 180 degrees, 270 degrees, 360 degrees, 450 degrees, and 540 degrees. Detorsion followed. The testicles were scanned at each torsion stop using both color Doppler velocity sonography and color Doppler energy sonography. Doppler parameters were optimized (by phantom and test scans) and maintained at a tolerable noise level throughout the experiment. Readers who were unaware of the degree of torsion compared flow in the rotated and contralateral control testes. Flow became undetectable by color Doppler velocity sonography and color Doppler energy sonography at 450 degrees in four of five cases and at 540 degrees in one of five cases. We found no significant difference between the velocity and the energy techniques for detecting this absence of flow (p > .05, Wilcoxon test). We found a significant difference in degree of flow for both techniques when comparing controls and all degrees of torsion combined (p < .006, Mann-Whitney test), but significance was achieved at lesser degrees of torsion with the velocity technique than with the energy technique (180 degrees and 360 degrees, respectively, Wilcoxon test). Color Doppler energy sonography was not significantly more sensitive than color Doppler velocity sonography for the diagnosis of spermatic cord torsion in this model. Complete occlusion of arterial inflow occurred at 450-540 degrees of torsion.

  13. Analysis of retrograde ejaculation using color Doppler ultrasonography before and after transurethral collagen injection.

    PubMed

    Nagai, A; Nasu, Y; Watanabe, M; Tsugawa, M; Iguchi, H; Kumon, H

    2004-10-01

    Transurethral bladder neck collagen injection therapy was performed in a patient with retrograde ejaculation. The phenomenon of retrograde ejaculation and its correction after the therapy were clearly demonstrated by color Doppler ultrasonography. To our knowledge this is the first report showing successful observation of retrograde ejaculation using color Doppler ultrasonography.

  14. Color Doppler ultrasound of the hand: observations on clinical utility in rheumatoid arthritis.

    PubMed

    Saadeh, Constantine; Gaylor, Patrick; Lee, Doohi; Malacara, Jan; Gaylor, Michael

    2004-02-01

    The use of ultrasound with color Doppler in the evaluation of rheumatoid arthritis was followed in 25 patients with joint complaints. Small joint ultrasound of the metacarpophalangeal joints (MCPs) as well as the wrists was performed with supplementation by color Doppler. In addition, 6 patients were followed for at least 3 months after start of treatment of rheumatoid arthritis using the same technique. In patients with what appeared to be definite rheumatoid arthritis, ultrasound supported this diagnosis as evidenced by the finding of cortical defects, extensor tendon sheath thickening, and synovial proliferation. Increased activity by color Doppler ultrasonography was the most common finding. Significant decrease in color Doppler activity was noted in the 6 patients who were followed up after 3 months of therapy with disease-modifying agents. Therefore, the use of ultrasound with color Doppler could aid in the diagnosis and follow up of patients with rheumatoid arthritis.

  15. Bubble-induced Color Doppler Feedback for Histotripsy Tissue Fractionation

    PubMed Central

    Miller, Ryan M.; Zhang, Xi; Maxwell, Adam; Cain, Charles; Xu, Zhen

    2016-01-01

    Histotripsy therapy produces cavitating bubble clouds to increasingly fractionate and eventually liquefy tissue using high intensity ultrasound pulses. Following cavitation generated by each pulse, coherent motion of the cavitation residual nuclei can be detected using metrics formed from ultrasound color Doppler acquisitions. In this paper, three experiments were performed to investigate the characteristics of this motion as real-time feedback on histotripsy tissue fractionation. In the first experiment, bubble-induced color Doppler (BCD) and particle image velocimetry (PIV) analysis monitored the residual cavitation nuclei in the treatment region in an agarose tissue phantom treated with 2-cycle histotripsy pulses at > 30 MPa using a 500 kHz transducer. Both BCD and PIV results showed brief chaotic motion of the residual nuclei followed by coherent motion first moving away from the transducer and then rebounding back. Velocity measurements from both PIV and BCD agreed well, showing a monotonic increase in rebound time up to a saturation point for increased therapy dose. In a second experiment, a thin layer of red blood cells (RBC) was added to the phantom to allow quantification of the fractionation of the RBC layer to compare with BCD metrics. A strong linear correlation was observed between the fractionation level and the time to BCD peak rebound velocity over histotripsy treatment. Finally, the correlation between BCD feedback and histotripsy tissue fractionation was validated in ex vivo porcine liver evaluated histologically. BCD metrics showed strong linear correlation with fractionation progression, suggesting that BCD provides useful quantitative real-time feedback on histotripsy treatment progression. PMID:26863659

  16. Blood flow velocity in monocular retinoblastoma assessed by color doppler

    PubMed Central

    Bonanomi, Maria Teresa B C; Saito, Osmar C; de Lima, Patricia Picciarelli; Bonanomi, Roberta Chizzotti; Chammas, Maria Cristina

    2015-01-01

    OBJECTIVE: To analyze the flow of retrobulbar vessels in retinoblastoma by color Doppler imaging. METHODS: A prospective study of monocular retinoblastoma treated by enucleation between 2010 and 2014. The examination comprised fundoscopy, magnetic resonance imaging, ultrasonography and color Doppler imaging. The peak blood velocities in the central retinal artery and central retinal vein of tumor-containing eyes (tuCRAv and tuCRVv, respectively) were assessed. The velocities were compared with those for normal eyes (nlCRAv and nlCRVv) and correlated with clinical and pathological findings. Tumor dimensions in the pathological sections were compared with those in magnetic resonance imaging and ultrasonography and were correlated with tuCRAv and tuCRVv. In tumor-containing eyes, the resistivity index in the central retinal artery and the pulse index in the central retinal vein were studied in relation to all variables. RESULTS: Eighteen patients were included. Comparisons between tuCRAv and nlCRAv and between tuCRVv and nlCRVv revealed higher velocities in tumor-containing eyes (p<0.001 for both), with a greater effect in the central retinal artery than in the central retinal vein (p=0.024). Magnetic resonance imaging and ultrasonography measurements were as reliable as pathology assessments (p=0.675 and p=0.375, respectively). A positive relationship was found between tuCRAv and the tumor volume (p=0.027). The pulse index in the central retinal vein was lower in male patients (p=0.017) and in eyes with optic nerve invasion (p=0.0088). CONCLUSIONS: TuCRAv and tuCRVv are higher in tumor-containing eyes than in normal eyes. Magnetic resonance imaging and ultrasonography measurements are reliable. The tumor volume is correlated with a higher tuCRAv and a reduced pulse in the central retinal vein is correlated with male sex and optic nerve invasion. PMID:26735219

  17. Shear wave transmissivity measurement by color Doppler shear wave imaging

    NASA Astrophysics Data System (ADS)

    Yamakoshi, Yoshiki; Yamazaki, Mayuko; Kasahara, Toshihiro; Sunaguchi, Naoki; Yuminaka, Yasushi

    2016-07-01

    Shear wave elastography is a useful method for evaluating tissue stiffness. We have proposed a novel shear wave imaging method (color Doppler shear wave imaging: CD SWI), which utilizes a signal processing unit in ultrasound color flow imaging in order to detect the shear wave wavefront in real time. Shear wave velocity is adopted to characterize tissue stiffness; however, it is difficult to measure tissue stiffness with high spatial resolution because of the artifact produced by shear wave diffraction. Spatial average processing in the image reconstruction method also degrades the spatial resolution. In this paper, we propose a novel measurement method for the shear wave transmissivity of a tissue boundary. Shear wave wavefront maps are acquired by changing the displacement amplitude of the shear wave and the transmissivity of the shear wave, which gives the difference in shear wave velocity between two mediums separated by the boundary, is measured from the ratio of two threshold voltages required to form the shear wave wavefronts in the two mediums. From this method, a high-resolution shear wave amplitude imaging method that reconstructs a tissue boundary is proposed.

  18. Influence of the Coanda effect on color Doppler jet area and color encoding. In vitro studies using color Doppler flow mapping.

    PubMed

    Chao, K; Moises, V A; Shandas, R; Elkadi, T; Sahn, D J; Weintraub, R

    1992-01-01

    We studied surface adherence and its effects on color Doppler jet areas and color encoding in an in vitro model with a noncompliant receiving chamber into which a steady flow jet was directed parallel to either a straight or a curved surface adjacent to and 4 mm away from the inflow orifice (1.50 mm2) with the control condition being a free jet matched for flow rates and driving pressures. Jets were imaged perpendicular to the plane of the surface, the plane in which most clinical images of jet-surface interactions are obtained. Ten different flow rates ranging from 0.13 to 0.30 l/min were used. Surface-adherent jet areas were smaller than control jets for every driving pressure-volume combination (paired t test, p less than 0.01). Computer analysis of color Doppler images showed more green and blue (reverse flow) pixels on the surface side of the adherent jets than the control jets (p less than 0.05), suggesting that viscous energy loss and flow deceleration and reversal play a role in the jet-surface interaction. Analysis of variance demonstrated that linear regression slopes of flow rate versus jet area for surface jets were lower (slopes, 11-21 cm2/l/min; r = 0.95-0.97) than those for the control (slope, 33 cm2/l/min; r = 0.97) (p less than 0.0001). Surface adherence (Coanda effect) influences jet size and color encoding, causing smaller color Doppler jet areas and greater variance and reverse velocity encoding.

  19. Transesophageal color Doppler evaluation of obstructive lesions using the new "Quasar" technology.

    PubMed

    Fan, P; Nanda, N C; Gatewood, R P; Cape, E G; Yoganathan, A P

    1995-01-01

    Due to the unavoidable problem of aliasing, color flow signals from high blood flow velocities cannot be measured directly by conventional color Doppler. A new technology termed Quantitative Un-Aliased Speed Algorithm Recognition (Quasar) has been developed to overcome this limitation. Employing this technology, we used transesophageal color Doppler echocardiography to investigate whether the velocities detected by the Quasar would correlate with those obtained by continuous-wave Doppler both in vitro and in vivo. In the in vitro study, a 5.0 MHz transesophageal transducer of a Kontron Sigma 44 color Doppler flow system was used. Fourteen different peak velocities calculated and recorded by color Doppler-guided continuous-wave Doppler were randomly selected. In the clinical study, intraoperative transesophageal echocardiography was performed using the same transducer 18 adults (13 aortic valve stenosis, 2 aortic and 2 mitral stenosis, 2 hypertrophic obstructive cardiomyopathy and 1 mitral valve stenosis). Following each continuous-wave Doppler measurement, the Quasar was activated, and a small Quasar marker was placed in the brightest area of the color flow jet to obtain the maximum mean velocity readout. The maximum mean velocities measured by Quasar closely correlated with maximum peak velocities obtained by color flow guided continuous-wave Doppler in both in vitro (0.53 to 1.65 m/s, r = 0.99) and in vivo studies (1.50 to 6.01 m/s, r = 0.97). We conclude that the new Quasar technology can accurately measure high blood flow velocities during transesophageal color Doppler echocardiography. This technique has the potential of obviating the need for continuous-wave Doppler.

  20. Color Doppler imaging of the retrobulbar vessels in diabetic retinopathy.

    PubMed

    Pauk-Domańska, Magdalena; Walasik-Szemplińska, Dorota

    2014-03-01

    Diabetes is a metabolic disease characterized by elevated blood glucose level due to impaired insulin secretion and activity. Chronic hyperglycemia leads to functional disorders of numerous organs and to their damage. Vascular lesions belong to the most common late complications of diabetes. Microangiopathic lesions can be found in the eyeball, kidneys and nervous system. Macroangiopathy is associated with coronary and peripheral vessels. Diabetic retinopathy is the most common microangiopathic complication characterized by closure of slight retinal blood vessels and their permeability. Despite intensive research, the pathomechanism that leads to the development and progression of diabetic retinopathy is not fully understood. The examinations used in assessing diabetic retinopathy usually involve imaging of the vessels in the eyeball and the retina. Therefore, the examinations include: fluorescein angiography, optical coherence tomography of the retina, B-mode ultrasound imaging, perimetry and digital retinal photography. There are many papers that discuss the correlations between retrobulbar circulation alterations and progression of diabetic retinopathy based on Doppler sonography. Color Doppler imaging is a non-invasive method enabling measurements of blood flow velocities in small vessels of the eyeball. The most frequently assessed vessels include: the ophthalmic artery, which is the first branch of the internal carotid artery, as well as the central retinal vein and artery, and the posterior ciliary arteries. The analysis of hemodynamic alterations in the retrobulbar vessels may deliver important information concerning circulation in diabetes and help to answer the question whether there is a relation between the progression of diabetic retinopathy and the changes observed in blood flow in the vessels of the eyeball. This paper presents the overview of literature regarding studies on blood flow in the vessels of the eyeball in patients with diabetic

  1. Color and power Doppler combined with Fetal Intelligent Navigation Echocardiography (FINE) to evaluate the fetal heart.

    PubMed

    Yeo, L; Romero, R

    2017-08-14

    To evaluate the performance of color and bidirectional power Doppler ultrasound combined with Fetal Intelligent Navigation Echocardiography (FINE) in examining the fetal heart. A prospective cohort study was conducted of fetuses in the second and third trimesters with a normal heart or with congenital heart disease (CHD). One or more spatiotemporal image correlation (STIC) volume datasets, combined with color or bidirectional power Doppler (S-flow) imaging, were acquired in the apical four-chamber view. Each successfully obtained STIC volume was evaluated by STICLoop™ to determine its appropriateness before applying the FINE method. Visualization rates for standard fetal echocardiography views using diagnostic planes and/or Virtual Intelligent Sonographer Assistance (VIS-Assistance®) were calculated for grayscale (removal of Doppler signal), color Doppler and S-flow Doppler. In four cases with CHD (one case each of tetralogy of Fallot, hypoplastic left heart and coarctation of the aorta, interrupted inferior vena cava with azygos vein continuation and asplenia, and coarctation of the aorta with tricuspid regurgitation and hydrops), the diagnostic potential of this new technology was presented. A total of 169 STIC volume datasets of the normal fetal heart (color Doppler, n = 78; S-flow Doppler, n = 91) were obtained from 37 patients. Only a single STIC volume of color Doppler and/or a single volume of S-flow Doppler per patient were analyzed using FINE. Therefore, 60 STIC volumes (color Doppler, n = 27; S-flow Doppler, n = 33) comprised the final study group. Median gestational age at sonographic examination was 23 (interquartile range, 21-27.5) weeks. Color Doppler FINE generated nine fetal echocardiography views (grayscale) using (1) diagnostic planes in 73-100% of cases, (2) VIS-Assistance in 100% of cases, and (3) a combination of diagnostic planes and/or VIS-Assistance in 100% of cases. The rate of generating successfully eight fetal echocardiography views

  2. [Graves' disease: ultrasonographic, color Doppler and histological aspects].

    PubMed

    Messina, G; Viceconti, N; Trinti, B

    1997-11-01

    The aim of the present work was to study the relationship between thyroid low echogenicity, the thyroid blood flow by color-Doppler (CD) and histological features in patients with Graves' disease (GD). Thyroid ultrasonography and CD was performed on 28 patients with GD. In 5 patients has been compared CD with histology. The thyroid volume was higher in 100% of patients with GD at the onset rather than in euthyroidism. Diffuse hypoechogenicity of the thyroid was discovered in 100% of patients with GD at the onset and it persisted in 57.1% of patients that became euthyroid after therapy. Qualitative CD resulted in different patterns that were classified as follow: pattern A ("thyroid inferno") in 17 patients (60.7%); pattern B (mildly increased of parenchymal blood flow) in 11 patients (39.3%). In the 5 histological proven cases, in the pattern A (3 cases) there was a diffuse microfollicular hyperplasia with functional activation notes. There was lymphocytic infiltration. While in the pattern B (two cases) there were a non-follicular hypercellular nodule with pseudocapsule and rare colloid. We conclude that there are two different histological types with different CD patterns in GD.

  3. Ultrasound Despeckling for Contrast Enhancement

    PubMed Central

    Tay, Peter C.; Garson, Christopher D.; Acton, Scott T.; Hossack, John A.

    2010-01-01

    Images produced by ultrasound systems are adversely hampered by a stochastic process known as speckle. A despeckling method based upon removing outlier is proposed. The method is developed to contrast enhance B-mode ultrasound images. The contrast enhancement is with respect to decreasing pixel variations in homogeneous regions while maintaining or improving differences in mean values of distinct regions. A comparison of the proposed despeckling filter is compared with the other well known despeckling filters. The evaluations of despeckling performance are based upon improvements to contrast enhancement, structural similarity, and segmentation results on a Field II simulated image and actual B-mode cardiac ultrasound images captured in vivo. PMID:20227984

  4. Acute venous thrombosis of a renal transplant: early detection with color Doppler sonography.

    PubMed

    Danse, E; Malaise, J; Mourad, M; Cosyns, J P

    2009-01-01

    The observation of a recent case of an acute venous thrombosis of a renal transplant is the opportunity to review and present the role of color Doppler sonography for the early detection of such a severe and uncommon complication.

  5. Using rotation for steerable needle detection in 3D color-Doppler ultrasound images.

    PubMed

    Mignon, Paul; Poignet, Philippe; Troccaz, Jocelyne

    2015-08-01

    This paper demonstrates a new way to detect needles in 3D color-Doppler volumes of biological tissues. It uses rotation to generate vibrations of a needle using an existing robotic brachytherapy system. The results of our detection for color-Doppler and B-Mode ultrasound are compared to a needle location reference given by robot odometry and robot ultrasound calibration. Average errors between detection and reference are 5.8 mm on needle tip for B-Mode images and 2.17 mm for color-Doppler images. These results show that color-Doppler imaging leads to more robust needle detection in noisy environment with poor needle visibility or when needle interacts with other objects.

  6. Experimental verification of color flow imaging based on wideband Doppler method.

    PubMed

    Tanaka, Naohiko

    2014-01-01

    The purpose of this study is to eliminate the aliasing in color flow imaging. The wideband Doppler method is applied to generate a color flow image, and the validity of the method is experimentally confirmed. The single beam experiment is carried out to confirm the velocity estimation based on the wideband Doppler method. The echo data for the conventional pulsed Doppler method and the wideband Doppler method are obtained using a flow model, and the estimated velocity for each method is compared. The color flow images for each method are also generated using several types of flow model. The generated images are compared, and the characteristics of the imaging based on the wideband Doppler method are discussed. The high velocity beyond the Nyquist limit is successfully estimated by the wideband Doppler method, and the availability in low velocity estimation is also confirmed. The aliasing in color flow images is eliminated, and the generated images show the significance of the elimination of the aliasing in the flow imaging. The aliasing in color flow imaging can be eliminated by the wideband Doppler method. This technique is useful for the exact understanding of blood flow dynamics.

  7. Comparing Color Doppler Ultrasonography and Angiography to Assess Traumatic Arterial Injuries of the Extremities

    PubMed Central

    Pezeshki Rad, Masoud; Mohammadifard, Mahyar; Ravari, Hassan; Farrokh, Donya; Ansaripour, Emad; Saremi, Elena

    2015-01-01

    Background: Traumatic events are one of the major causes of arterial injuries. Physical examination is not a good predictor of the extent of injuries and arteriography is considered as the gold standard for this purpose. In the recent years, noninvasive modalities are increasingly replacing diagnostic arteriography. Color Doppler ultrasonography (USG) is an excellent method to investigate arterial diseases. Objectives: The present study aimed to evaluate the diagnostic value of color Doppler USG compared to conventional angiography in traumatic arterial injuries of extremities. Patients and Methods: Seventy-five patients with extremity trauma suspicious for arterial injury were examined by color Doppler USG just before angiography. Doppler pattern and flow states were assessed, then angiography was performed. The results of duplex USG were compared with angiography. Results: Color Doppler USG had a sensitivity of 95% and specificity of 98% in diagnosis of arterial injury. Positive and negative predictive values of Doppler USG were 92.5% and 94.2%, respectively. Conclusions: Color Doppler USG can be used as a reliable modality with acceptable sensitivity and specificity values to screen hemodynamically stable patients with limb trauma suspicious for arterial injury. PMID:25785180

  8. Color Doppler energy: computer analysis of color to assess angle dependency and detection of volume flow differences.

    PubMed

    Nilsson, A; Olofsson, P A; Lorén, I; Carlstedt, L; Nilsson, P

    1997-04-01

    The aims of this study were to assess (1) any angle dependency of color Doppler energy and (2) if computer analysis of the color can distinguish variations in volume flow. Fluid flowing through a silicon tube in a waterbath was insonated and the color in the images analyzed by a computer. The color presentation on the screen decreases rapidly as the angle approaches 90 degrees. At angles that did not produce a saturation of the color in the tube, the computer analysis detected significant differences between different flow volumes. We have concluded that monitoring of volume flow changes by analysis of color Doppler energy is possible, but the angle of insonation must be taken into account.

  9. Localization of needle tip with color doppler during pericardiocentesis: In vitro validation and initial clinical application

    NASA Technical Reports Server (NTRS)

    Armstrong, G.; Cardon, L.; Vilkomerson, D.; Lipson, D.; Wong, J.; Rodriguez, L. L.; Thomas, J. D.; Griffin, B. P.

    2001-01-01

    This study evaluates a new device that uses color Doppler ultrasonography to enable real-time image guidance of the aspirating needle, which has not been possible until now. The ColorMark device (EchoCath Inc, Princeton, NJ) induces high-frequency, low-amplitude vibrations in the needle to enable localization with color Doppler. We studied this technique in 25 consecutive patients undergoing pericardiocentesis, and in vitro, in a urethane phantom with which the accuracy of color Doppler localization of the needle tip was compared with that obtained by direct measurement. Tip localization was excellent in vitro; errors axial to the ultrasound beam (velocity Doppler -0.13 +/- 0.90 mm, power Doppler -0.05 +/- 1.7 mm) were less than lateral errors (velocity -0.36 +/- 1.8 mm, power -0.02 +/- 2.8 mm). In 18 of 25 patients, the needle was identified and guided into the pericardial space with the ColorMark technique, and it allowed successful, uncomplicated drainage of fluid. Initial failures were the result of incorrect settings on the echocardiographic machine and inappropriate combinations of the needle puncture site and imaging window. This study demonstrates a novel color Doppler technique that is highly accurate at localizing a needle tip. The technique is feasible for guiding pericardiocentesis. Further clinical validation of this technique is required.

  10. Use of ultrasound, color Doppler imaging and radiography to monitor periapical healing after endodontic surgery.

    PubMed

    Tikku, Aseem P; Kumar, Sunil; Loomba, Kapil; Chandra, Anil; Verma, Promila; Aggarwal, Renu

    2010-09-01

    This study evaluated the effectiveness of ultrasound, color Doppler imaging and conventional radiography in monitoring the post-surgical healing of periapical lesions of endodontic origin. Fifteen patients who underwent periapical surgery for endodontic pathology were randomly selected. In all patients, periapical lesions were evaluated preoperatively using ultrasound, color Doppler imaging and conventional radiography, to analyze characteristics such as size, shape and dimensions. On radiographic evaluation, dimensions were measured in the superoinferior and mesiodistal direction using image-analysis software. Ultrasound evaluation was used to measure the changes in shape and dimensions on the anteroposterior, superoinferior, and mesiodistal planes. Color Doppler imaging was used to detect the blood-flow velocity. Postoperative healing was monitored in all patients at 1 week and 6 months by using ultrasound and color Doppler imaging, together with conventional radiography. The findings were then analyzed to evaluate the effectiveness of the 3 imaging techniques. At 6 months, ultrasound and color Doppler imaging were significantly better than conventional radiography in detecting changes in the healing of hard tissue at the surgical site (P < 0.004). This study demonstrates that ultrasound and color Doppler imaging have the potential to supplement conventional radiography in monitoring the post-surgical healing of periapical lesions of endodontic origin.

  11. Localization of needle tip with color doppler during pericardiocentesis: In vitro validation and initial clinical application

    NASA Technical Reports Server (NTRS)

    Armstrong, G.; Cardon, L.; Vilkomerson, D.; Lipson, D.; Wong, J.; Rodriguez, L. L.; Thomas, J. D.; Griffin, B. P.

    2001-01-01

    This study evaluates a new device that uses color Doppler ultrasonography to enable real-time image guidance of the aspirating needle, which has not been possible until now. The ColorMark device (EchoCath Inc, Princeton, NJ) induces high-frequency, low-amplitude vibrations in the needle to enable localization with color Doppler. We studied this technique in 25 consecutive patients undergoing pericardiocentesis, and in vitro, in a urethane phantom with which the accuracy of color Doppler localization of the needle tip was compared with that obtained by direct measurement. Tip localization was excellent in vitro; errors axial to the ultrasound beam (velocity Doppler -0.13 +/- 0.90 mm, power Doppler -0.05 +/- 1.7 mm) were less than lateral errors (velocity -0.36 +/- 1.8 mm, power -0.02 +/- 2.8 mm). In 18 of 25 patients, the needle was identified and guided into the pericardial space with the ColorMark technique, and it allowed successful, uncomplicated drainage of fluid. Initial failures were the result of incorrect settings on the echocardiographic machine and inappropriate combinations of the needle puncture site and imaging window. This study demonstrates a novel color Doppler technique that is highly accurate at localizing a needle tip. The technique is feasible for guiding pericardiocentesis. Further clinical validation of this technique is required.

  12. Fuzzy-Contextual Contrast Enhancement.

    PubMed

    Parihar, Anil; Verma, Om; Khanna, Chintan

    2017-02-08

    This paper presents contrast enhancement algorithms based on fuzzy contextual information of the images. We introduce fuzzy similarity index and fuzzy contrast factor to capture the neighborhood characteristics of a pixel. A new histogram, using fuzzy contrast factor of each pixel is developed, and termed as the fuzzy dissimilarity histogram (FDH). A cumulative distribution function (CDF) is formed with normalized values of FDH and used as a transfer function to obtain the contrast enhanced image. The algorithm gives good contrast enhancement and preserves the natural characteristic of the image. In order to develop a contextual intensity transfer function, we introduce a fuzzy membership function based on fuzzy similarity index and coefficient of variation of the image. The contextual intensity transfer function is designed using the fuzzy membership function to achieve final contrast enhanced image. The overall algorithm is referred as the fuzzy contextual contrast-enhancement (FCCE) algorithm. The proposed algorithms are compared with conventional and state-of-art contrast enhancement algorithms. The quantitative and visual assessment of the results is performed. The results of quantitative measures are statistically analyzed using t-test. The exhaustive experimentation and analysis show the proposed algorithm efficiently enhances contrast and yields in natural visual quality images.

  13. Contrast-enhanced ultrasound with SonoVue in the evaluation of postoperative complications in pediatric liver transplant recipients

    PubMed Central

    Bonini, G.; Pezzotta, G.; Morzenti, C.; Agazzi, R.; Nani, R.

    2007-01-01

    Purpose To evaluate the utility of contrast-enhanced sonography in the study of pediatric liver transplant recipients and its potential impact in reducing the need for invasive diagnostic procedures. Materials and methods From October 2002 to December 2003 we performed routine color Doppler ultrasound and contrast-enhanced ultrasound studies on 30 pediatric patients who had undergone liver transplantation. Findings indicative of complications were confirmed with invasive studies (angiography, computed tomography, and PTC). Results Contrast-enhanced sonography correctly identified four of the five cases of hepatic artery thrombosis and all those involving the portal (n = 6) and hepatic vein (n = 3) thrombosis. It failed to identify one case of hepatic artery thrombosis characterized by collateral circulation arising from the phrenic artery and the single case of hepatic artery stenosis. The latter was more evident on color Doppler, which revealed a typical tardus parvus waveform. The use of contrast offered no significant advantages in the study of biliary complications although it did provide better visualization of bile leaks. Conclusions Contrast-enhanced sonography improves diagnostic confidence and reduces the need for more invasive imaging studies in the postoperative follow-up of pediatric liver transplant recipients. PMID:23396596

  14. The role of the acoustic radiation force in color Doppler twinkling artifacts

    PubMed Central

    2015-01-01

    Purpose: The aim of this experimental study was to evaluate whether the acoustic radiation force (ARF) is a potential source of twinkling artifacts in color Doppler images. Methods: Color Doppler images were obtained using a clinical ultrasonic scanner (Voluson e, GE Healthcare) for a high contrast (+15 dB) circular scattering phantom at pulse repetition frequencies (PRFs) ranging from 0.1 to 13 kHz. Ultrasound transmissions resulting in ARF were measured using a hydrophone at the various PRFs considered. The influence of ARF on the appearance of twinkling colors was examined via the common parameter PRF. This methodology is based on the fact that alternating positive and negative Doppler shifts induced by the ARF are centered at a PRF twice the maximum Doppler frequency on the color scale bar, whereas the twinkling color aliasing is expected to remain similar regardless of PRF. Results: Color twinkling artifacts were observed to be most conspicuous at the lowest PRF of 0.1 kHz. The extent of twinkling rapidly decreased as the PRF increased, eventually disappearing when the PRF ≥0.6 kHz. The measured ultrasound transmissions, however, were found to be insensitive to the PRF, and therefore it can be inferred that the PRF was insensitive to the ARF. Conclusion: Based on our experimental observations, the ARF may not be a source of color Doppler twinkling artifacts. PMID:25754365

  15. Color Doppler energy imaging in the diagnosis of fetal intracranial hemorrhage in the second trimester.

    PubMed

    Guerriero, S; Ajossa, S; Mais, V; Risalvato, A; Angiolucci, M; Labate, F; Lai, M P; Melis, G B

    1997-09-01

    Unlike conventional color Doppler imaging; color Doppler energy (or power Doppler) displays the intensity of the returning Doppler signal, is less dependent on the orientation of the blood vessel, and is therefore better able to detect low blood velocities. For these reasons it could be useful in some investigations which are difficult to perform, such as transvaginal evaluation of fetal brain vessels. We report a case of a fetal intracranial hyperechoic lesion detected at 26 weeks by transabdominal sonography in a severely growth-retarded fetus. There was absence of diastolic flow in the umbilical artery and low impedance to diastolic flow in the middle cerebral arteries. The fetus was further investigated by transvaginal sonography for the evaluation of the nature and localization of the lesion and an intraventricular hemorrhage in the right brain parenchyma with disorganized supratentorial brain structure was observed. As color Doppler energy imaging is more sensitive to slow flow, it was more reliable than conventional Doppler imaging in confirming the absence of flow within and around the hyperechoic lesion in contrast to the normal vascularity of the contralateral ventricular system. After informed parental counselling, the mother, for psychological reasons, asked to be delivered by Cesarean section. The fetus died 24 h after birth. The autopsy corroborated the ultrasonographic diagnosis. This case report confirms the accuracy of transvaginal ultrasonography in the diagnosis of intracranial hemorrhage and suggests a specific role for color Doppler energy imaging.

  16. A new fringeline-tracking approach for color Doppler ultrasound imaging phase unwrapping

    NASA Astrophysics Data System (ADS)

    Saad, Ashraf A.; Shapiro, Linda G.

    2008-03-01

    Color Doppler ultrasound imaging is a powerful non-invasive diagnostic tool for many clinical applications that involve examining the anatomy and hemodynamics of human blood vessels. These clinical applications include cardio-vascular diseases, obstetrics, and abdominal diseases. Since its commercial introduction in the early eighties, color Doppler ultrasound imaging has been used mainly as a qualitative tool with very little attempts to quantify its images. Many imaging artifacts hinder the quantification of the color Doppler images, the most important of which is the aliasing artifact that distorts the blood flow velocities measured by the color Doppler technique. In this work we will address the color Doppler aliasing problem and present a recovery methodology for the true flow velocities from the aliased ones. The problem is formulated as a 2D phase-unwrapping problem, which is a well-defined problem with solid theoretical foundations for other imaging domains, including synthetic aperture radar and magnetic resonance imaging. This paper documents the need for a phase unwrapping algorithm for use in color Doppler ultrasound image analysis. It describes a new phase-unwrapping algorithm that relies on the recently developed cutline detection approaches. The algorithm is novel in its use of heuristic information provided by the ultrasound imaging modality to guide the phase unwrapping process. Experiments have been performed on both in-vitro flow-phantom data and in-vivo human blood flow data. Both data types were acquired under a controlled acquisition protocol developed to minimize the distortion of the color Doppler data and hence to simplify the phase-unwrapping task. In addition to the qualitative assessment of the results, a quantitative assessment approach was developed to measure the success of the results. The results of our new algorithm have been compared on ultrasound data to those from other well-known algorithms, and it outperforms all of them.

  17. Color Doppler energy: computer analysis for detection of volume flow variations.

    PubMed

    Nilsson, A; Olofsson, P A; Lorén, I; Carlstedt, L; Nilsson, P

    1997-10-01

    The aims of this study were to (1) determine whether analysis of a color Doppler energy image can show small differences in volume flow and (2) determine the performance characteristics of color Doppler energy to aid future analyses. Flow through a silicone tube in a waterbath was insonated, and the images were analyzed by computer producing arbitrary values for the different flow volumes at different machine settings. A significant difference in the derived values was found at volume low changes of 10 ml/min. The differences are most pronounced when small amounts of color are shown in the vessel. This region of high sensitivity can be altered by changing the machine settings of filter, scale, or level. The angle of insonation must be taken into account. In conclusion, computer analysis of color Doppler energy can monitor changes in blood flow volume with a high sensitivity.

  18. Power and color Doppler ultrasound settings for inflammatory flow: impact on scoring of disease activity in patients with rheumatoid arthritis.

    PubMed

    Torp-Pedersen, Søren; Christensen, Robin; Szkudlarek, Marcin; Ellegaard, Karen; D'Agostino, Maria Antonietta; Iagnocco, Annamaria; Naredo, Esperanza; Balint, Peter; Wakefield, Richard J; Torp-Pedersen, Arendse; Terslev, Lene

    2015-02-01

    To determine how settings for power and color Doppler ultrasound sensitivity vary on different high- and intermediate-range ultrasound machines and to evaluate the impact of these changes on Doppler scoring of inflamed joints. Six different types of ultrasound machines were used. On each machine, the factory setting for superficial musculoskeletal scanning was used unchanged for both color and power Doppler modalities. The settings were then adjusted for increased Doppler sensitivity, and these settings were designated study settings. Eleven patients with rheumatoid arthritis (RA) with wrist involvement were scanned on the 6 machines, each with 4 settings, generating 264 Doppler images for scoring and color quantification. Doppler sensitivity was measured with a quantitative assessment of Doppler activity: color fraction. Higher color fraction indicated higher sensitivity. Power Doppler was more sensitive on half of the machines, whereas color Doppler was more sensitive on the other half, using both factory settings and study settings. There was an average increase in Doppler sensitivity, despite modality, of 78% when study settings were applied. Over the 6 machines, 2 Doppler modalities, and 2 settings, the grades for each of 7 of the patients varied between 0 and 3, while the grades for each of the other 4 patients varied between 0 and 2. The effect of using different machines, Doppler modalities, and settings has a considerable influence on the quantification of inflammation by ultrasound in RA patients, and this must be taken into account in multicenter studies. Copyright © 2015 by the American College of Rheumatology.

  19. Computer aided diagnosis system for breast cancer based on color Doppler flow imaging.

    PubMed

    Liu, Yan; Cheng, H D; Huang, J H; Zhang, Y T; Tang, X L; Tian, J W; Wang, Y

    2012-12-01

    Color Doppler flow imaging takes a great value in diagnosing and classifying benign and malignant breast lesions. However, scanning of color Doppler sonography is operator-dependent and ineffective. In this paper, a novel breast classification system based on B-Mode ultrasound and color Doppler flow imaging is proposed. First, different feature extraction methods were used to obtain the texture and geometric features from B-Mode ultrasound images. In color Doppler feature extraction stage, several spectrum features are extracted by applying blood flow velocity analysis to Doppler signals. Moreover, a velocity coherent vector method is proposed based on color coherence vector, which is helpful for designing to the optimize detection of flow indices from different blood flow velocity fields automatically. Finally, a support vector machine classifier with selected feature vectors is used to classify breast tumors into benign and malignant. The experimental results demonstrate that the proposed computer-aided diagnosis system is useful for reducing the unnecessary biopsy and death rate.

  20. [Chronic arterial mesenteric ischemia: Doppler color ultrasonography demonstration of collateral flow].

    PubMed

    Danse, E M; Hammer, F; Matondo, H; Dardenne, A N; Geubel, A; Goffette, P

    2001-11-01

    Two cases of atypical mesenteric ischemia where color Doppler US demonstration of the underlying arterial abnormality and collateral supply was possible are presented. Significant stenosis of the celiac axis and thrombosis of the SMA were clearly depicted, along with the presence of collateral arterial supply. Endovascular treatment was successful in both cases. These cases confirm the possibility of detecting collateral flow at Doppler imaging in patients with mesenteric ischemia, both for diagnosis of mesenteric ischemia and endovascular treatment planning.

  1. Color Doppler sonography in the study of chronic ischemic nephropathy.

    PubMed

    Meola, M; Petrucci, I

    2008-06-01

    In western countries, the risk of cardiovascular disease has increased considerably in recent decades. This trend has been paralleled by an increase in cases of atherosclerotic renal disease, which is related to the improved prognosis of cardiovascular diseases, aging, and the increasing mean age of the general population. It is reasonable to expect that in the near future, there will be a sharp increase in the number of elderly patients with atherosclerotic vascular disease in chronic dialysis programs. The result will be a dramatic rise in the social and economic costs of dialysis that could constitute a true clinical emergency. In this epidemiologic scenario, one of the most important targets of 21st century nephrology will be the early diagnosis of chronic ischemic nephropathy and the development of new and more effective strategies for its treatment.Color Doppler (CD) ultrasonography has displayed high sensitivity, specificity, and positive and negative predictive values in the diagnosis of this disease in selected population, making it an ideal tool for use in screening programs. Eligibility for screening should be based on clinical criteria. For the most part, it will be aimed at adults (especially those who are elderly) with atherosclerotic vascular disease involving multiple districts and chronic kidney disease (CKD), stage 2-3, in the absence of a documented history of renal disease. In these patients, hypertension may be a secondary manifestation or a symptom of the ischemic nephropathy itself. The objectives of sonographic screening should be (1) to identify subjects in the population at risk who are affected by stenosis of the main renal artery (RAS); (2) to identify and characterize patients without RAS who have chronic ischemic nephropathy caused by nephroangiosclerosis and/or atheroembolic disease. The former group will require second-level diagnostic studies or angioplasty with stenting; the latter can be managed conservatively. The most important

  2. Graphics processing unit-based high-frame-rate color Doppler ultrasound processing.

    PubMed

    Chang, Li-Wen; Hsu, Ke-Hsin; Li, Pai-Chi

    2009-09-01

    Color Doppler ultrasound is a routinely used diagnostic tool for assessing blood flow information in real time. The required signal processing is computationally intensive, involving autocorrelation, linear filtering, median filtering, and thresholding. Because of the large amount of data and high computational requirement, color Doppler signal processing has been mainly implemented on custom-designed hardware, with software-based implementation--particularly on a general-purpose CPU--not being successful. In this paper, we describe the use of a graphics processing unit for implementing signal-processing algorithms for color Doppler ultrasound that achieves a frame rate of 160 fps for frames comprising 500 scan lines x 128 range samples, with each scan line being obtained from an ensemble size of 8 with an 8-tap FIR clutter filter.

  3. Color Doppler US of the postoperative penis: anatomy and surgical complications.

    PubMed

    Bertolotto, Michele; Serafini, Giovanni; Savoca, Gianfranco; Liguori, Giovanni; Calderan, Loretta; Gasparini, Cristiana; Mucelli, Roberto Pozzi

    2005-01-01

    A number of surgical procedures that significantly change the penile anatomy and vasculature can be used to manage pathologic conditions of the penis (eg, congenital and acquired deformities, erectile dysfunction, priapism). Phallic reconstruction surgery can be used for sex reassignment and after penile amputation or for correction of congenital malformations. Color Doppler ultrasonography (US) clearly depicts the normal penile anatomy and postoperative changes (eg, changes of the tunica albuginea, extraalbugineal pathologic fluid collections, cavernosal tissue changes produced by scars and fibrosis). It is also effective in evaluating surgery-related complications and determining the causes of erectile dysfunction and other unsatisfactory long-term results. Moreover, color Doppler US of the penile vessels and vascular anastomoses following revascularization allows direct evaluation of flow characteristics, shunt patency, and venous engorgement. Color Doppler US is the imaging modality of choice in evaluating patients who have undergone penile surgery.

  4. Analysis of human ejaculation using color Doppler ultrasonography: a comparison between antegrade and retrograde ejaculation.

    PubMed

    Nagai, Atsushi; Watanabe, Masami; Nasu, Yasutomo; Iguchi, Hiroki; Kusumi, Norihiro; Kumon, Hiromi

    2005-02-01

    To observe the phenomenon of human ejaculation dynamically using color Doppler ultrasonography. Human ejaculation was observed using transrectal color Doppler ultrasonography in a healthy man and a patient with retrograde ejaculation. Ejaculation was induced manually with audiovisual sexual stimulation. The ejaculatory phenomenon was analyzed and compared with that of retrograde ejaculation. In the healthy man, the prostatic urethra flattened slightly and the bladder neck contracted just before expulsion. The ejaculatory stream spurted from the seminal vesicles to the bulbous urethra through the ejaculatory duct. In the patient with retrograde ejaculation, the ejaculatory stream from the seminal vesicles and inframontanal and distal prostatic urethras distended into a globular-shaped sac filled with semen. No seminal flow toward the bulbous urethra occurred. The semen remaining in the prostatic urethra began flowing slowly into the bladder. Differences between antegrade and retrograde ejaculation can be clearly detected by color Doppler ultrasonography, providing a noninvasive method to diagnose ejaculatory disorders.

  5. Color-Doppler US features of a pyogenic granuloma of the upper dorsum tongue.

    PubMed

    Cantisani, Vito; Del Vecchio, Alessandro; Fioravanti, Eloisa; Romeo, Umberto; D'Ambrosio, Ferdinando

    2016-03-01

    The diagnosis of oral lesions is based on clinical history, clinical examination and imaging exams. Different imaging modalities are available for the diagnosis and follow-up of these lesions such as computed tomography, magnetic resonance imaging, color-Doppler ultrasound, angiography and positron emission tomography. To date, color-Doppler ultrasound is considered the first-line imaging approach since it provides a non-invasive, cost-effective, real-time evaluation of oral anomalies. It provides both morphological and vascular information which are useful to determine the best therapeutic options. Differential diagnosis of a bleeding lobular mass of the tongue is, however, not always easy and includes several vascular and non-vascular lesions. We present herein a case of pyogenic granuloma of the tongue that at Color-Doppler US appeared as hypervascular lesion.

  6. [Echo-color Doppler in the study of hypothyroidism in the adult].

    PubMed

    Lagalla, R; Caruso, G; Benza, I; Novara, V; Calliada, F

    1993-09-01

    Color-Doppler US was performed on 20 patients with sub-clinic hypothyroidism which had been confirmed by laboratory tests. In all cases, color-Doppler US showed increased parenchymal flow, whose semiology was similar to the one known as "thyroid inferno" and currently associated, in the literature, with diffuse hyperfunction conditions. Quantitative measurements yielded no further element for differential diagnosis, while showing high flow speeds which were similar to those in hyperfunction. On the basis of consequent physiopathologic considerations, hypervascularization, as observed in hypothyroidism, is likely to be referred to the hypertrophic action of TSH, which was reported as high in all patients. In conclusion, the color-Doppler "thyroid inferno" pattern, which has been to date considered as specific of thyroid hyperfunction, has lost part of its diagnostic specificity, and further investigation--e.g. hormonal titers, scintigraphy--is needed for an unquestionable diagnosis to be made.

  7. Automated assessment of noninvasive filling pressure using color Doppler M-mode echocardiography

    NASA Technical Reports Server (NTRS)

    Greenberg, N. L.; Firstenberg, M. S.; Cardon, L. A.; Zuckerman, J.; Levine, B. D.; Garcia, M. J.; Thomas, J. D.

    2001-01-01

    Assessment of left ventricular filling pressure usually requires invasive hemodynamic monitoring to follow the progression of disease or the response to therapy. Previous investigations have shown accurate estimation of wedge pressure using noninvasive Doppler information obtained from the ratio of the wave propagation slope from color M-mode (CMM) images and the peak early diastolic filling velocity from transmitral Doppler images. This study reports an automated algorithm that derives an estimate of wedge pressure based on the spatiotemporal velocity distribution available from digital CMM Doppler images of LV filling.

  8. [Kidney obstruction: potential use of ultrasonography and Doppler color ultrasonography].

    PubMed

    Bertolotto, M; Perrone, R; Rimondini, A

    2000-12-01

    Ultrasonography is the first imaging approach in evaluation of patients with urinary obstruction. Presence of hydronephrosis, urinomas and inflammatory complications can be assessed. Moreover, the level and the cause of obstruction are often identified. The major limits of ultrasonography are poor visibility of the lumbar portion of the urinary tract and lack of specificity in detection of pyelocaliectasis. These limits are partially overcome with Doppler studies. Several factors can bias diagnostic accuracy of colour Doppler ultrasonography in evaluating renal obstruction; in particular, partial or intermittent obstruction cause minimum hemodynamic changes in patients with renal colic. Sensitivity of colour Doppler ultrasonography to detect obstruction decreases following medical treatment with NSAID and increases following hydration and diuretics administration. Diuretic ultrasound, colour Doppler evaluation of ureteral jets and evaluation of the twinkling artefact of stones are useful imaging techniques as well. Tissue harmonic imaging is a new imaging technique available in most latest generation US equipments. Evaluation of the kidney and of the urinary tract improves using this technique due to artefact reduction and increased contrast resolution.

  9. Color Doppler sonography as an adjunct to repeat uterine evacuation for gestational trophoblastic disease: case report.

    PubMed

    Tsuyoshi, Hideaki; Sugita, Genki; Kurokawa, Tetsuji; Yoshida, Yoshio

    2013-01-01

    Repeat uterine evacuation is a therapeutic option for preserving fertility in patients with gestational trophoblastic neoplasms and chemoresistance, but remains controversial due to the risks of hemorrhage and perforation. A 25-year-old patient with low-risk gestational trophoblastic neoplasm became chemoresistant; however, chemotherapy reduced intrauterine tumor vascularity as observed by color Doppler sonography, suggesting that patients could undergo uterine evacuation without major risk of bleeding. After 18 months, she achieved a normal pregnancy. Serial assessment of tumor vascularity with color Doppler sonography may provide information regarding the appropriate time to perform a repeat uterine evacuation without significant bleeding. Copyright © 2013 Wiley Periodicals, Inc.

  10. Management of pseudoaneurysm of the leg: is Color Doppler US enough?

    PubMed

    Pagliariccio, G; Catalini, R; Giantomassi, L; Angelini, A

    2010-06-01

    The authors describe two clinical cases showing that Color Doppler Ultrasonography (US) examination is effective and sufficient in the presence of a clinical suspicion of pseudoaneurysm. In cases of iatrogenic damage and post-traumatic lesions, US provides an easy and accurate diagnosis depicting the location and the morphology of the false aneurysm. The patient can thus be referred to appropriate treatment without undergoing further diagnostic examinations. Moreover, regardless of the performed treatment, Color Doppler US is an efficient non-invasive diagnostic tool in the follow-up.

  11. Effects of diagnostic levels of color Doppler ultrasound energy on the cell cycle of newborn rats.

    PubMed

    Zhu, J; Lin, J; Zhu, Z; Shou, W; Bi, D; Shi, L

    1999-04-01

    Our objective was to evaluate the safety of diagnostic levels of color Doppler ultrasound energy in the field of obstetrics and to provide the experimental data for its clinical application. After insonating pregnant rats with diagnostic levels of color Doppler ultrasound energy, we studied the cell cycles of the newborn rats by flow cytometry and factorial analysis. We found that the deoxyribonucleic acid content was not affected in any phase of the cell cycle in newborn rats by any of the different insonation times and frequencies.

  12. Color Doppler energy in prenatal diagnosis of meconium peritonitis: a case report.

    PubMed

    Tseng, C W; Chao, A S; Chang, F H; Chang, S Y; Soong, Y K

    1997-03-01

    Meconium peritonitis is an uncommon chemical peritonitis of a fetus resulting from antenatal bowel perforation. We reported a case of meconium peritonitis with pseudocystic formation diagnosed by color Doppler energy (CDE) at 34 gestational weeks. An echogenic substance inside a fetal abdominal mass was detected using ultrasound. By conventional color Doppler, there was minimal blood flow in the cystic wall or septums of the mass. Using CDE, bowel hyperperistalsis was observed in multiple small bowel loops and the region of intestinal loops into the mass was easily detected. Therefore, the angle independent nature of CDE will play a significant role in the early and accurate diagnosis of meconium peritonitis before birth.

  13. Green tagging in displaying color Doppler aliasing: a comparison to standard color mapping in renal artery stenosis.

    PubMed

    Gao, Jing; Mennitt, Kevin; Belfi, Lily; Zheng, Yuan-Yi; Chen, Zong; Rubin, Jonathan M

    2013-11-01

    To quantitatively assess the contrast-to-noise ratio (CNR) of green tagging and standard color flow images in displaying fast flow velocity, we retrospectively reviewed 20 cases of hemodynamically significant renal artery stenosis (RAS) detected by renal color Doppler ultrasound and confirmed with digital subtraction angiography. At the site of RAS, blood flow with high velocity that appeared as aliasing on color flow images was computationally analyzed with both green tagging and standard color mapping. To assess the difference in the CNR between normal background flow and the aliased signal as a function of visualizing aliasing between the two color mappings, we used GetColorpixels (Chongqing Medical University, Chongqing, China) to count the values in the color channels after segmenting color pixels from gray-scale pixels. We then calculated the CNR in each color channel-red, green, and blue (RGB)--in the aliasing region on green tagging and standard color mapping. The CNRs in the red, green and blue channels were 0.35 ± 0.44, 1.11 ± 0.41 and 0.51 ± 0.19, respectively, on standard color mapping, and 0.97 ± 0.80, 4.01 ± 1.36 and 0.64 ± 0.29, respectively, on green tagging. We used a single-factor analysis of variance and two-tailed t-test to assess the difference in CNR in each color channel between the two color mappings at the site of RAS. With these comparisons, there was no significant difference in the CNR in the red or blue channel between green tagging and standard color mapping (p > 0.05). However, there was a statistically significant difference in the CNR in the green channel between the two color mappings (p = 0.00019). Furthermore, the CNR measured in the green channel on the green tagging image was significantly higher than the CNRs in all other color channels on both color mapping images (p = 0.000). Hence, we conclude that green tagging has significantly higher visibility as a function of high-velocity flow than standard color mapping. The

  14. Can color doppler predict the uniformity of HIFU-induced prostate tissue destruction?

    PubMed

    Rouvière, Olivier; Curiel, Laura; Chapelon, Jean-Yves; Bouvier, Raymonde; Ecochard, René; Gelet, Albert; Lyonnet, Denis

    2004-09-01

    Tissue blood perfusion influences the results of some hyperthermia and thermotherapy procedures, but its role in the outcome of prostate cancer treatment by high-intensity focused ultrasound (HIFU) has not been evaluated yet. We evaluated preoperative prostate color Doppler as a predictor of the efficacy of HIFU treatment. Thirty-five patients underwent pre- and post-contrast color Doppler examination of the prostate before HIFU treatment. Specific software was used to calculate, on color Doppler images, the color pixel density (CPD), and the specific flow (SF, i.e., mean velocity x CPD) in different regions of interest. Post-treatment sextant biopsies were obtained in 31 patients, 5.8 +/- 2.8 months after HIFU treatment. No significant correlation was found between the uniformity of HIFU-induced tissue destruction observed on control biopsies and the pre-treatment CPD/SF values in any region of interest, either before or after contrast injection. On the other hand, history of radiation therapy was significantly associated with homogeneous tissue destruction and history of hormone therapy was significantly associated with incomplete tissue destruction. Color Doppler cannot predict the uniformity of HIFU-induced tissue destruction. History of radiation therapy was found to be a factor of favorable prognosis and history of hormone therapy was found to be a factor of poor prognosis in our population.

  15. Accurate evaluation of axillary sentinel lymph node metastasis using contrast-enhanced ultrasonography with Sonazoid in breast cancer: a preliminary clinical trial.

    PubMed

    Matsuzawa, Fumihiko; Omoto, Kiyoka; Einama, Takahiro; Abe, Hironori; Suzuki, Takashi; Hamaguchi, Jun; Kaga, Terumi; Sato, Mami; Oomura, Masako; Takata, Yumiko; Fujibe, Ayako; Takeda, Chie; Tamura, Etsuya; Taketomi, Akinobu; Kyuno, Kenichi

    2015-01-01

    Breast cancer is the most common type of cancer in women. The 5-year survival rate in patients with breast cancer ranges from 74 to 82 %. Sentinel lymph node biopsy has become an alternative to axillary lymph node dissection for nodal staging. We evaluated the detection of the sentinel lymph node and metastasis of the lymph node using contrast enhanced ultrasonography with Sonazoid. Between December 2013 and May 2014, 32 patients with operable breast cancer were enrolled in this study. We evaluated the detection of axillary sentinel lymph nodes and the evaluation of axillary lymph nodes metastasis using contrast enhanced computed tomography, color Doppler ultrasonography and contrast enhanced ultrasonography with Sonazoid. All the sentinel lymph nodes were identified, and the sentinel lymph nodes detected by contrast enhanced ultrasonography with Sonazoid corresponded with those detected by computed tomography lymphography and indigo carmine method. The detection of metastasis based on contrast enhanced computed tomography were sensitivity 20.0 %, specificity 88.2 %, PPV 60.0 %, NPV 55.6 %, accuracy 56.3 %. Based on color Doppler ultrasonography, the results were sensitivity 36.4 %, specificity 95.2 %, PPV 80.0 %, NPV 74.1 %, accuracy 75.0 %. Based on contrast enhanced ultrasonography with Sonazoid, the results were sensitivity 81.8 %, specificity 95.2 %, PPV 90.0 %, NPV 90.9 %, accuracy 90.6 %. The results suggested that contrast enhanced ultrasonography with Sonazoid was the most accurate among the evaluations of these modalities. In the future, we believe that our method would take the place of conventional sentinel lymph node biopsy for an axillary staging method.

  16. pO polarography, contrast enhanced color duplex sonography (CDS), [18F] fluoromisonidazole and [18F] fluorodeoxyglucose positron emission tomography: validated methods for the evaluation of therapy-relevant tumor oxygenation or only bricks in the puzzle of tumor hypoxia?

    PubMed

    Gagel, Bernd; Piroth, Marc; Pinkawa, Michael; Reinartz, Patrick; Zimny, Michael; Kaiser, Hans J; Stanzel, Sven; Asadpour, Branka; Demirel, Cengiz; Hamacher, Kurt; Coenen, Heinz H; Scholbach, Thomas; Maneschi, Payam; DiMartino, Ercole; Eble, Michael J

    2007-06-28

    The present study was conducted to analyze the value of ([18F] fluoromisonidazole (FMISO) and [18F]-2-fluoro-2'-deoxyglucose (FDG) PET as well as color pixel density (CPD) and tumor perfusion (TP) assessed by color duplex sonography (CDS) for determination of therapeutic relevant hypoxia. As a standard for measuring tissue oxygenation in human tumors, the invasive, computerized polarographic needle electrode system (pO2 histography) was used for comparing the different non invasive measurements. Until now a total of 38 Patients with malignancies of the head and neck were examined. Tumor tissue pO2 was measured using a pO2-histograph. The needle electrode was placed CT-controlled in the tumor without general or local anesthesia. To assess the biological and clinical relevance of oxygenation measurement, the relative frequency of pO2 readings, with values < or = 2.5, < or = 5.0 and < or = 10.0 mmHg, as well as mean and median pO2 were stated. FMISO PET consisted of one static scan of the relevant region, performed 120 min after intravenous administration. FMISO tumor to muscle ratios (FMISOT/M) and tumor to blood ratios (FMISOT/B) were calculated. FDG PET of the lymph node metastases was performed 71 +/- 17 min after intravenous administration. To visualize as many vessels as possible by CDS, a contrast enhancer (Levovist, Schering Corp., Germany) was administered. Color pixel density (CPD) was defined as the ratio of colored to grey pixels in a region of interest. From CDS signals two parameters were extracted: color hue--defining velocity (v) and color area--defining perfused area (A). Signal intensity as a measure of tissue perfusion (TP) was quantified as follows: TP = vmean x Amean. In order to investigate the degree of linear association, we calculated the Pearson correlation coefficient. Slight (|r| > 0.4) to moderate (|r| > 0.6) correlation was found between the parameters of pO2 polarography (pO2 readings with values < or = 2.5, < or = 5.0 and < or = 10.0 mm

  17. pO polarography, contrast enhanced color duplex sonography (CDS), [18F] fluoromisonidazole and [18F] fluorodeoxyglucose positron emission tomography: validated methods for the evaluation of therapy-relevant tumor oxygenation or only bricks in the puzzle of tumor hypoxia?

    PubMed Central

    Gagel, Bernd; Piroth, Marc; Pinkawa, Michael; Reinartz, Patrick; Zimny, Michael; Kaiser, Hans J; Stanzel, Sven; Asadpour, Branka; Demirel, Cengiz; Hamacher, Kurt; Coenen, Heinz H; Scholbach, Thomas; Maneschi, Payam; DiMartino, Ercole; Eble, Michael J

    2007-01-01

    Background The present study was conducted to analyze the value of ([18F] fluoromisonidazole (FMISO) and [18F]-2-fluoro-2'-deoxyglucose (FDG) PET as well as color pixel density (CPD) and tumor perfusion (TP) assessed by color duplex sonography (CDS) for determination of therapeutic relevant hypoxia. As a standard for measuring tissue oxygenation in human tumors, the invasive, computerized polarographic needle electrode system (pO2 histography) was used for comparing the different non invasive measurements. Methods Until now a total of 38 Patients with malignancies of the head and neck were examined. Tumor tissue pO2 was measured using a pO2-histograph. The needle electrode was placed CT-controlled in the tumor without general or local anesthesia. To assess the biological and clinical relevance of oxygenation measurement, the relative frequency of pO2 readings, with values ≤ 2.5, ≤ 5.0 and ≤ 10.0 mmHg, as well as mean and median pO2 were stated. FMISO PET consisted of one static scan of the relevant region, performed 120 min after intravenous administration. FMISO tumor to muscle ratios (FMISOT/M) and tumor to blood ratios (FMISOT/B) were calculated. FDG PET of the lymph node metastases was performed 71 ± 17 min after intravenous administration. To visualize as many vessels as possible by CDS, a contrast enhancer (Levovist®, Schering Corp., Germany) was administered. Color pixel density (CPD) was defined as the ratio of colored to grey pixels in a region of interest. From CDS signals two parameters were extracted: color hue – defining velocity (v) and color area – defining perfused area (A). Signal intensity as a measure of tissue perfusion (TP) was quantified as follows: TP = vmean × Amean. Results In order to investigate the degree of linear association, we calculated the Pearson correlation coefficient. Slight (|r| > 0.4) to moderate (|r| > 0.6) correlation was found between the parameters of pO2 polarography (pO2 readings with values ≤ 2.5, ≤ 5

  18. Value of contrast-enhanced ultrasound in rheumatic disease.

    PubMed

    Klauser, Andrea Sabine

    2005-12-01

    Ultrasound (US) is a useful tool in the assessment of rheumatic disease. It permits assessment of early erosive changes and vascularity detection in synovial proliferation, caused by inflammatory activity by using colour/power Doppler US (CDUS/PDUS). In the detection of slow flow and flow in small vessels, the CDUS/PDUS technique is limited. Contrast enhanced US can improve the detection of inflammatory vascularity but is not yet included in routine diagnosis of this condition. However, contrast enhanced US shows promising results in diagnosis, assessment of disease activity and follow up of inflammatory rheumatic diseases.

  19. Diagnosis of adnexal malignancies by using color Doppler energy imaging as a secondary test in persistent masses.

    PubMed

    Guerriero, S; Ajossa, S; Risalvato, A; Lai, M P; Mais, V; Angiolucci, M; Melis, G B

    1998-04-01

    The purpose of this prospective study was to compare the accuracy of B-mode transvaginal ultrasonography alone and in combination with color Doppler energy (or power Doppler) imaging in differentiating benign from malignant adnexal masses. A total of 192 consecutive persistent adnexal masses (159 benign, 33 malignant) were studied before surgery by B-mode transvaginal ultrasonography with and without color Doppler energy. In addition, CA-125 plasma levels were determined and spectral Doppler analysis was performed. By color Doppler energy imaging, a mass was considered malignant when arterial flow was visualized in an echogenic portion of a mass defined as malignant by B-mode. Intratumoral arterial blood flow could be readily detected by color Doppler energy imaging in all malignant tumors and in 94% of the benign tumors. The combined use of transvaginal B-mode ultrasonography and color Doppler energy imaging has greater accuracy in the diagnosis of ovarian malignancies than transvaginal ultrasonography alone (value of kappa: 0.81 and 0.63, respectively), reducing the number of false-positive results. The use of spectral Doppler analysis was of limited diagnostic value, with a kappa value of 0.17 for the pulsatility index (< 1) and of 0.41 for the resistance index (< 0.4). Also, the association with CA-125 increased the number of false-negative results. In conclusion, the use of color Doppler energy imaging seems to be a useful secondary test when a mass is suspected to be malignant by B-mode ultrasonography.

  20. Color-coded Doppler evaluation of cholecystic varices in portal hypertension.

    PubMed

    Kainberger, F M; Vergesslich, K A; Eilenberger, M; Poeltner, S; Ponhold, W

    1990-01-01

    A 11-year-old white girl presented with a diagnosis of thrombosis of the portal vein after newborn septicemia. Duplex sonography revealed significant narrowing of the portal vein and its right and left branches. A Doppler signal could only be obtained in certain short segments of the portal vein and indicated hepatopetal flow. Color-coded Doppler sonography showed extensive varicose veins in the gallbladder with a bigger draining vessel running to the porta hepatis. Documentation of varices like those in the gallbladder wall confirms the diagnosis of portal hypertension and may increase the sensitivity of Doppler sonography. Color mapping has the potential to detect unexpected flow and to analyze blood flow to better advantage.

  1. Prognosis of ischemic colitis: comparison of color doppler sonography with early clinical and laboratory findings.

    PubMed

    Danse, E M; Van Beers, B E; Jamart, J; Hoang, P; Laterre, P F; Thys, F C; Kartheuser, A; Pringot, J

    2000-10-01

    The objective of this study was to compare the value of color Doppler sonography with early clinical and laboratory findings in determining the prognosis of patients with ischemic colitis. We reviewed the early clinical, laboratory, and color Doppler sonographic data of 24 patients with ischemic colitis. The patients were divided into two groups on the basis of their outcome. The first group comprised the patients with transient ischemia who recovered uneventfully, and the second group included the patients who needed surgery because of symptomatic transmural colic gangrene or colic stricture. Clinical data and laboratory values were compared with color Doppler sonographic findings including colic wall thickness, presence of stratification, and arterial flow in the bowel wall. At univariate analysis, increased age (p = 0.007), leukocyte count (p = 0.030), lactate dehydrogenase level (p = 0.030), blood lactate level (p = 0.041), and absence of vascular flow in the colic wall (p<0.001) were significantly related to complicated ischemic colitis. At multivariate analysis, absence of arterial flow was the only significant predictor of complicated ischemic colitis (p = 0.002), with a sensitivity of 82%, a specificity of 92%, a positive predictive value of 90%, and a negative predictive value of 86%. Absence of arterial flow in the wall of the ischemic colon on initial color Doppler sonography is suggestive of an unfavorable outcome and is more closely associated with outcome than early clinical and laboratory findings.

  2. [Identification of cervical lymph node micrometastasis of tongue cancer by color Doppler and MRI].

    PubMed

    Fan, Sufeng; Zhang, Quan; Li, Qiuli; Wang, Lina; Zheng, Lie; Liu, Longzhong

    2014-01-01

    To assess the values of color Doppler and magnetic resonance imaging (MRI) in the identification of cervical lymph node micrometastasis of tongue cancer. Totally 96 cases of tongue cancer with impalpable neck lymph node was examined with color Doppler and MRI within one week before surgery. Chi-square test was used to assess if the presence of regional lymph node micrometastasis, histopathological analysis as a golden standard lymph node micrometastasis. For the diagnosis of cervical lymph node micrometastasis, color Doppler was significantly better than MRI in sensitivity (72.5% vs 50.0%, P = 0.039) and the accuracy (78.1% vs 64.6%, P = 0.038), but no significant difference in the specificity (82.1% vs 75.0%, P = 0.357), the positive predictive value (74.4% vs 58.8%, P = 0.159) and the negative predictive value (80.7% vs 67.7%, P = 0.108). Color Doppler is better than MRI in the sensitivity and accuracy for the diagnosis of cervical lymph node micrometastasis of tongue cancer.

  3. A strategy for reducing the mortality rate from vasa previa using transvaginal sonography with color Doppler.

    PubMed

    Oyelese, K O; Schwärzler, P; Coates, S; Sanusi, F A; Hamid, R; Campbell, S

    1998-12-01

    Vasa previa is a cause of sudden unanticipated fetal death, with a fetal mortality of 33-100%. Transvaginal sonography (TVS) and color Doppler may aid in making the diagnosis antenatally, allowing elective Cesarean delivery, thereby avoiding fetal death from exsanguination which would occur if the membranes were allowed to rupture in labor. Whilst it is not feasible to screen all pregnant women for vasa previa, antenatal examination with TVS and color Doppler of women at risk, specifically those with low-lying placentas, bi-lobed, multi-lobed and succenturiate-lobed placentas, multiple pregnancies and pregnancies resulting from in vitro fertilization may lead to antenatal diagnosis of the condition. We present the last three cases of vasa previa to have occurred in our institution, two of which were diagnosed antenatally using TVS and color Doppler. In all three cases, routine 20-week obstetric sonography revealed low-lying placentas; in only one of these did the placenta remain low at term. A low-lying placenta at 20 weeks may be a risk factor for vasa previa; we suggest that further studies be carried out to ascertain this. Judicious use of TVS and color Doppler in women considered at risk of vasa previa may help to reduce the mortality from this condition.

  4. Amniotic fluid index measured with the aid of color flow Doppler.

    PubMed

    Zlatnik, M G; Olson, G; Bukowski, R; Saade, G R

    2003-04-01

    To determine whether using color flow Doppler to identify the umbilical cord affects amniotic fluid index (AFI) measurements. A total of 2236 AFI measurements between 24 and 42 weeks in singleton gestations with no known or suspected fetal anomalies and < 14 days' discrepancy between menstrual and ultrasonographic dating were included. Color flow Doppler was used to identify loops of umbilical cord; these were excluded from the measurement. Polynomial regression was used to generate means and centiles. Data were grouped according to completed weeks of gestation and descriptive statistics were calculated. At each week of gestation, the number and percentage of pregnancies diagnosed as < or = 2.5th, < or = 5th, > or = 95th, and > or = 97.5th centile according to a 'standard' nomogram derived without using color flow Doppler were calculated. The AFI decreased significantly over gestational age, starting at 31 weeks (p < 0.05 by ANOVA). The relationship between AFI and gestational age was best modeled by a second-degree polynomial (p < 0.001). The median and range of the proportion of AFIs that fell outside the ranges of the standard nomogram at each completed gestational age was: 6.0 (2.3-35.4)% for the < or = 2.5th centile, 9.9 (3.1-37.5)% for the < or = 5th centile, 3.8 (0-30)% for the > or = 95th centile, and 1.8 (0-20)% for the > or = 97.5th centile. The 2.5th and 5th centiles using the current data were lower than those of the 'standard', and the difference increased with advancing gestation. Upper centiles were also different. The AFI measured using color flow Doppler overestimates oligohydramnios and may underestimate polyhydramnios when a standard AFI table obtained without color flow Doppler is used. Normal values specific for measurement method should be used for reference.

  5. Evaluation of bovine luteal blood flow by using color Doppler ultrasonography.

    PubMed

    Lüttgenau, J; Bollwein, H

    2014-04-01

    Since luteal vascularization plays a decisive role for the function of the corpus luteum (CL), the investigation of luteal blood flow (LBF) might give valuable information about the physiology and patho-physiology of the CL. To quantify LBF, usually Power mode color Doppler ultrasonography is used. This method detects the number of red blood cells moving through the vessels and shows them as color pixels on the B-mode image of the CL. The area of color pixels is measured with computer-assisted image analysis software and is used as a semiquantitative parameter for the assessment of LBF. Although Power mode is superior for the evaluation of LBF compared to conventional color Doppler ultrasonography, which detects the velocity of blood cells, it is still not sufficiently sensitive to detect the blood flow in the small vessels in the center of the bovine CL. Therefore, blood flow can only be measured in the bigger luteal vessels in the outer edge of the CL. Color Doppler ultrasonographic studies of the bovine estrous cycle have shown that plasma progesterone (P4) concentration can be more reliably predicted by LBF than by luteal size (LS), especially during the CL regression. During the midluteal phase, cows with low P4 level showed smaller CL, but LBF, related to LS, did not differ between cows with low and high P4 levels. In contrast to non-pregnant cows, a significant rise in LBF was observed three weeks after insemination in pregnant cows. However, LBF was not useful for an early pregnancy diagnosis due to high LBF variation among cows. When the effects of an acute systemic inflammation and exogenous hormones on the CL are examined, the LBF determination is more sensitive than LS assessment. In conclusion, color Doppler ultrasonography of the bovine CL provides additional information on luteal function compared to measurements of LS and plasma P4, but its value as a parameter concerning assessment of fertility in cows has to be clarified.

  6. Spinal arteriovenous malformation: use of intraoperative color Doppler ultrasonography guidance for surgical resection. Case report.

    PubMed

    Baskan, Ozdil; Durdag, Emre; Geyik, Serdar; Elmaci, Ilhan

    2014-12-01

    Spinal arteriovenous malformations (AVMs) may be associated with sensory and motor deficits, bowel or bladder dysfunction, radicular pain or deficit, and back pain. Hemorrhage can occur in the parenchyma leading to the acute onset of symptoms. Neurosurgical resection is one of the way of treatment. Several techniques including intraoperative angiography, dye-injection and the micro Doppler method have proven to be useful during the surgical resection of spinal vascular lesions. Herein, we report our experience with intraoperative ultrasonography (IOUS) and color Doppler ultrasonography guidance for visualizing a spinal cord AVM during surgery. IOUS is a time-saving and noninvasive method for intraoperative imaging of spinal AVM.

  7. [Color Doppler evaluation and diagnosis of local complications after arterial endovascular procedures].

    PubMed

    Novelli, Marco; Righi, Daniele; Pilato, Alida

    2012-09-01

    Diagnostic and therapeutic percutaneous endovascular procedures have become more and more common in recent years, and so also the number of local complications has increased. After such procedures a simple clinical examination may show the presence of an inguinal mass, but does not permit a diagnosis, while Color Doppler and Duplex Scanner can make a differential diagnosis between hematoma, pseudoaneurysm, arteriovenous fistula or other disease. Color Doppler is ubiquitously used to diagnose such complications as it offers a low-cost, easy-to-use method, only minimally uncomfortable for the patient. This ultrasound system can provide both anatomic and haemodynamic information. Our study highlights the diagnostic possibilities offered by the Color Doppler and Duplex Scanner and details, using many illustrations and examples, how the most common complications such as hematoma, pseudoaneurysm, arteriovenous fistula and thrombosis are imaged. Hematoma appears as a hypoechogenic zone, with no color inside, as flow is not present. Pseudoaneurysms, unlike hematoma, maintain a connection with an injured blood vessel, and so they show blood flow both inside the lesion and in the communicating channel, with a typical pattern. The arteriovenous fistula is a vascular channel created, after a percutaneous procedure, between an artery and an adjacent vein that have both been damaged. An endovascular thrombus is directly shown as a luminal defect of flow. Other less common complications are discussed and illustrated.

  8. Regional cerebral blood flow estimates in newborn lamb using amplitude-mode color Doppler ultrasound.

    PubMed

    Taylor, G A

    1996-01-01

    To establish the feasibility of determining changes in regional cerebral blood flow using amplitude-mode color Doppler ultrasound in the newborn lamb. Regional cerebral blood flow was modified by intrastriatal injection of N -methyl-D-aspartic acid (NMDA) in two newborn lambs and compared with that in a control animal receiving only intrastriatal saline. Serial color Doppler ultrasound energy images were obtained in coronal projection at the level of the foramen of Monro, before and at 20, 40, and 60 min after NMDA or saline injection using a 7.0-MHz linear transducer. Real-time images were obtained and transferred onto a computer workstation. Regions of interest were drawn over each striatum and cerebral hemisphere and were analyzed for mean pixel intensity (MPI) at each interval. Paired regional cerebral blood flow (r-CBF) determinations (radiolabeled microsphere technique) were also obtained in every animal. MPI and r-CBF for each anatomic region were compared using linear regression. Mean color pixel intensities increased significantly in the ipsilateral basal ganglia and cerebral hemisphere (p < 0.0001) in both animals injected with NMDA, but not in the animal injected with normal saline (p < 0.63). A strong and significant linear correlation was found between MPI and r-CBF for striatum (r = 0.89, p < 0.0001) and cerebral hemisphere (r = 0.85, p < 0.0001). Amplitude-mode color Doppler ultrasound shows potential for technically simple determination of serial changes in regional cerebral blood flow in infants.

  9. Comparison of foetomaternal circulation in normal pregnancies and pregnancy induced hypertension using color Doppler studies.

    PubMed

    Gupta, Shikha; Misra, R; Ghosh, U K; Gupta, V; Srivastava, D

    2014-01-01

    The aim of present study was to assess fetomaternal blood flows in normal and abnormal pregnancies using color Doppler indices. Subjects were divided into two groups as: Group A of 25 subjects of normal pregnancy as controls and group B of 25 subjects of pregnancy induced hypertension. All the subjects were lying in the age-group of 25-35 years and having 28 to 34 weeks of gestation; the patients were evaluated by detailed history and were subjected to complete general examination. Blood pressure was taken on two occasions at least 6 hours apart. Systemic examination and obstetrical examination was done in all subjects. All cases were subjected to pathological tests- Haemogram, Test for proteins in urine. Ultrasound assessment of fetal growth was done by measuring BPD (Biparietal diameter), HC (Head circumference), FL (Femur length) and AC (Abdominal circumference): Average gestational age and effective fetal weight was then calculated by ultrasound machine. Color Doppler was used to assess the various Doppler indices indices: Pulsatility index (PI), Resistive index (RI) and Systolic diastolic ratio (S/D ratio) in bilateral uterine, umbilical and middle cerebral arteries and compared to the standard normograms. Percentage of subjects having abnormal Doppler indices were calculated. Assessment of percentage of SGA (small for gestational age) fetuses was done in all the three groups. Decline in mean values of all Doppler indices was found with advancing gestational age in normal pregnancy suggesting decreased vascular resistance and increased blood flow in fetomaternal circulation. In pregnancy induced hypertensives, the mean values of Doppler indices showed a decline as in normal pregnancy but showed an increase (more than 2 S.D. of the mean) for that gestational age in comparison to the control group suggesting increased impedance to blood flow in uteroplacental and fetomaternal circulation. Umbilical artery Doppler indices were found to be the most sensitive

  10. Commercialization of vein contrast enhancement

    NASA Astrophysics Data System (ADS)

    Lovhoiden, Gunnar; Deshmukh, Harshal; Vrancken, Carlos; Zhang, Yong; Zeman, Herbert D.; Weinberg, Devin

    2003-07-01

    An ongoing clinical study of an experimental infrared (IR) device, the Vein Contrast Enhancer (VCE) that visualizes surface veins for medical access, indicates that a commercial device with the performance of the existing VCE would have significant clinical utility for even a very skilled phlebotomist. A proof-of-principle prototype VCE device has now been designed and constructed that captures IR images of surface veins with a commercial CCD camera, transfers the images to a PC for real-time software image processing to enhance the vein contrast, and projects the enhanced images back onto the skin with a modified commercial LCD projector. The camera and projector are mounted on precision slides allowing for precise mechanical alignment of the two optical axes and for measuring the effects of axes misalignment. Precision alignment of the captured and projected images over the entire field-of-view is accomplished electronically by software adjustments of the translation, scaling, and rotation of the enhanced images before they are projected back onto the skin. This proof-of-principle prototype will be clinically tested and the experience gained will lead to the development of a commercial device, OnTarget!, that is compact, easy to use, and will visualize accessible veins in almost all subjects needing venipuncture.

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

    PubMed

    Marret, H; Ecochard, R; Giraudeau, B; Golfier, F; Raudrant, D; Lansac, J

    2002-12-01

    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. 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. 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. Sonographic analysis of adnexal masses including color Doppler energy shows the

  12. Role of color-Doppler US in the evaluation of scrotal edema.

    PubMed

    Quiligotti, Caterina; Merico, Valentina; Bortolotto, Chandra

    2013-10-10

    Ultrasound (US) examination in combination with color-Doppler US is the imaging modality of choice for evaluating the scrotum. Scrotal conditions are generally divided into testicular and extratesticular disorders; the latter may affect the epididymis, the spermatic cord, the tunica vaginalis, the skin and the subcutaneous tissue. The embryology of the scrotal contents is complex and has a number of anatomical and clinical consequences. We present the case of a patient with extraosseous Ewing's sarcoma of the thigh and ipsilateral scrotal swelling caused by lymphatic edema secondary to inguinal lymph node involvement. US combined with color-Doppler allowed differentiation between lymphoma or neoplastic involvement and lymphedema or vascular edema. If the US operator is thoroughly familiar with the scrotal lymphatic and vascular system, US imaging can help identify the pathogenesis of the edema and provide the clinicians and surgeons with important information.

  13. Image analysis of placental issues using three-dimensional ultrasound and color power doppler

    NASA Astrophysics Data System (ADS)

    Wang, Qi; Cheng, Qiong; Liu, J. G.

    2007-12-01

    With the development of birthing-process medical science, and insurance requirement of prepotency, the ultrasound technique is widely used in the application of obstetrics realm, especially on the monitoring of embryo's growth. In the recent decade, the introduction of high resolution three-dimensional ultrasonic and color power Doppler scanner provides a much more direct, sensitive, forerunner method for the monitoring of embryo and gravida's prediction. A novel method that depends on examining images of vasculature of placenta to determine the growth of embryo is introduced in this paper. First, get a set of placenta vascularity images of the pregnant woman, taken by Color Doppler Ultrasonic Scanner, then mark some points in these images, where we get a section image, thus we can observe the internal blood vessel distribution at those points. This method provides an efficient tool for doctors.

  14. New method to obtain ultrasonic angle independent Doppler color images using a sector transducer.

    PubMed

    Fei, D Y; Fu, C T

    1999-01-01

    A new method based on the multiple beam procedure to obtain ultrasonic angle independent Doppler color (AIDC) images using Doppler color imaging with a sector transducer has been developed. The transducer was sequentially placed at three locations with different direction orientations to acquire velocity information for the same flow field. Equations have been derived and used to obtain the velocity amplitude and flow direction angle for each point in the flow field from the acquired velocity data and the known positions of the transducer. AIDC images then can be reconstructed. To evaluate the feasibility of this method, AIDC images using a sector transducer have been reconstructed for steady flow fields in a latex tube model and for blood flow in the abdominal aorta of normal human subjects. The quantitative results obtained using this method were in reasonably good agreement with those obtained from existing reference methods.

  15. Practical application of color Doppler ultrasonography in patients with ejaculatory dysfunction.

    PubMed

    Hara, Ryoei; Nagai, Atsushi; Fujii, Tomohiro; Fukumoto, Kazuhiko; Ohira, Shin; Jo, Yoshimasa; Yokoyama, Teruhiko; Miyaji, Yoshiyuki

    2015-06-01

    We describe two cases in which dynamic analysis of ejaculation using color Doppler ultrasonography was useful in diagnosis of ejaculatory dysfunction and planning of therapy. The first patient was a 32-year-old man with a diagnosis of retrograde ejaculation. A bladder neck collagen injection was carried out, as the main cause was thought to be the bladder neck remaining open during ejaculation. The patient had antegrade ejaculation 1 week later. The second patient was a 48-year-old man with a diagnosis of anorgasmia accompanied by decreased seminal emission and insufficient function of the rhythmic pelvic striated muscles. The patient was prescribed etilefrine hydrochloride 15 mg/day. The symptom improved 2 weeks after starting this drug. These cases suggest that the use of color Doppler ultrasonography during ejaculation can improve the understanding of ejaculatory dysfunction and therapy for this condition. © 2015 The Japanese Urological Association.

  16. Oxygen consumption estimation with combined color doppler ultrasound and photoacoustic microscopy: a phantom study

    NASA Astrophysics Data System (ADS)

    Jiang, Yan; Harrison, Tyler; Forbrich, Alex; Zemp, Roger J.

    2011-03-01

    The metabolic rate of oxygen consumption (MRO2) quantifies tissue metabolism, which is important for diagnosis of many diseases. For a single vessel model, the MRO2 can be estimated in terms of the mean flow velocity, vessel crosssectional area, total concentration of hemoglobin (CHB), and the difference between the oxygen saturation (sO2) of blood flowing into and out of the tissue region. In this work, we would like to show the feasibility to estimate MRO2 with our combined photoacoustic and high-frequency ultrasound imaging system. This system uses a swept-scan 25-MHz ultrasound transducer with confocal dark-field laser illumination optics. A pulse-sequencer enables ultrasonic and laser pulses to be interlaced so that photoacoustic and Doppler ultrasound images are co-registered. Since the mean flow velocity can be measured by color Doppler ultrasound, the vessel cross-sectional area can be measured by power Doppler or photoacoustic imaging, and multi-wavelength photoacoustic methods can be used to estimate sO2 and CHB, all of these parameters necessary for MRO2 estimation can be provided by our system. Experiments have been performed on flow phantoms to generate co-registered color Doppler and photoacoustic images. To verify the sO2 estimation, two ink samples (red and blue) were mixed in various concentration ratios to mimic different levels of sO2, and the result shows a good match between the calculated concentration ratios and actual values.

  17. Temporal variability of vena contracta and jet areas with color Doppler in aortic regurgitation: a chronic animal model study.

    PubMed

    Ishii, M; Jones, M; Shiota, T; Yamada, I; Sinclair, B; Heinrich, R S; Yoganathan, A P; Sahn, D J

    1998-11-01

    The purpose of our study was to determine the temporal variability of regurgitant color Doppler jet areas and the width of the color Doppler imaged vena contracta for evaluating the severity of aortic regurgitation. Twenty-nine hemodynamically different states were obtained pharmacologically in 8 sheep 20 weeks after surgery to produce aortic regurgitation. Aortic regurgitation was quantified by peak and mean regurgitant flow rates, regurgitant stroke volumes, and regurgitant fractions determined using pulmonary and aortic electromagnetic flow probes and meters balanced against each other. The regurgitant jet areas and the widths of color Doppler imaged vena contracta were measured at 4 different times during diastole to determine the temporal variability of this parameter. When measured at 4 different temporal points in diastole, a significant change was observed in the size of the color Doppler imaged regurgitant jet (percent of difference: from 31.1% to 904%; 233% +/- 245%). Simple linear regression analysis between each color jet area at 4 different periods in diastole and flow meter-based severity of the aortic regurgitation showed only weak correlation (0.23 < r < 0.49). In contrast, for most conditions only a slight change was observed in the width of the color Doppler imaged vena contracta during the diastolic regurgitant period (percent of difference, vena contracta: from 2.4% to 12.9%, 5.8% +/- 3.2%). In addition, for each period the width of the color Doppler imaged vena contracta at the 4 different time periods in diastole correlated quite strongly with volumetric measures of the severity of aortic regurgitation (0.81 < r < 0.90) and with the instantaneous flow rate for the corresponding period (0.85 < r < 0.87). Color Doppler imaged vena contracta may provide a simple, practical, and accurate method for quantifying aortic regurgitation, even when using a single frame color Doppler flow mapping image.

  18. Value of superb microvascular imaging ultrasonography in the diagnosis of carpal tunnel syndrome: Compared with color Doppler and power Doppler.

    PubMed

    Chen, Jie; Chen, Li; Wu, Lei; Wang, Rui; Liu, Ji-Bin; Hu, Bing; Jiang, Li-Xin

    2017-05-01

    The aim of this study was to compare the value of superb microvascular imaging (SMI) in carpal tunnel syndrome (CTS) with that of color Doppler ultrasonography (CDUS) and power Doppler ultrasonography (PDUS).Fifty patients with symptomatic CTS and 25 healthy volunteers were enrolled. The cross-sectional area (CSA), CDUS score, PDUS score, and SMI score of the median nerve (MN) at the carpal tunnel were recorded. The value of different ultrasonography (US) diagnostic strategies was calculated.The blood flow display ratio in the MN of the healthy volunteers had no statistical difference between CDUS, PDUS, and SMI (20%, 32%, and 48%, respectively, P >.05). The blood flow display ratio for SMI in patients was significantly higher than that of CDUS and PDUS (90%, 52%, and 60%, respectively, P <.005). The accuracy of SMI score ≥2 (79%) was much higher than that of CDUS and PDUS (61% and 63%, respectively, P <.05). Comprehensive consideration of SMI and CSA, CSA≥10.5 mm, and/or SMI score ≥2 has the highest accuracy (83%), significantly higher than that of CSA combination with CDUS or PDUS (68% and 69%, respectively, P <.05).SMI is more sensitive to display the blood flow in the MN with CTS than CDUS and PDUS. It might significantly improve the diagnosis value for CTS.

  19. Wandering Spleen: Whirlpool Appearance in Color Doppler Ultrasonography. A Case Report

    PubMed Central

    MOHAMMADI, Afshin; GHASEMI-RAD, Mohammad

    2015-01-01

    Wandering spleen is an unusual surgical condition that is generally asymptomatic, but the long and mobile vascular pedicle of the spleen predisposes it to torsion. Various imaging modalities can be used to diagnose a wandering spleen. We present the case of a 23 year-old female patient with abdominal pain, in whom torsion of the spleen was diagnosed preoperatively, using color Doppler sonography, as a whirlpool appearance. PMID:26225153

  20. Wandering Spleen: Whirlpool Appearance in Color Doppler Ultrasonography. A Case Report.

    PubMed

    Mohammadi, Afshin; Ghasemi-Rad, Mohammad

    2015-03-01

    Wandering spleen is an unusual surgical condition that is generally asymptomatic, but the long and mobile vascular pedicle of the spleen predisposes it to torsion. Various imaging modalities can be used to diagnose a wandering spleen. We present the case of a 23 year-old female patient with abdominal pain, in whom torsion of the spleen was diagnosed preoperatively, using color Doppler sonography, as a whirlpool appearance.

  1. Role of color Doppler in differentiation of Graves' disease and thyroiditis in thyrotoxicosis

    PubMed Central

    Donkol, Ragab Hani; Nada, Aml Mohamed; Boughattas, Sami

    2013-01-01

    AIM: To evaluate the role of thyroid blood flow assessment by color-flow Doppler ultrasonography in the differential diagnosis of thyrotoxicosis and compare it to technetium pertechnetate thyroid scanning. METHODS: Twenty-six patients with thyrotoxicosis were included in the study. Clinical history was taken and physical examination and thyroid function tests were performed for all patients. Thyroid autoantibodies were measured. The thyroid glands of all patients were evaluated by gray scale ultrasonography for size, shape and echotexture. Color-flow Doppler ultrasonography of the thyroid tissue was performed and spectral flow analysis of both inferior thyroid arteries was assessed. Technetium99 pertechnetate scanning of the thyroid gland was done for all patients. According to thyroid scintigraphy, the patients were divided into two groups: 18 cases with Graves’ disease and 8 cases with Hashimoto’s thyroiditis. All patients had suppressed thyrotropin. The diagnosis of Graves’ disease and Hashimoto’s thyroiditis was supported by the clinical picture and follow up of patients. RESULTS: Peak systolic velocities of the inferior thyroid arteries were significantly higher in patients with Graves’ disease than in patients with thyroiditis (P = 0.004 in the right inferior thyroid artery and P = 0.001 in left inferior thyroid artery). Color-flow Doppler ultrasonography parameters demonstrated a sensitivity of 88.9% and a specificity of 87.5% in the differential diagnosis of thyrotoxicosis. CONCLUSION: Color Doppler flow of the inferior thyroid artery can be used in the differential diagnosis of thyrotoxicosis, especially when there is a contraindication of thyroid scintigraphy by radioactive material in some patients. PMID:23671754

  2. Contrast Enhancement Based on Intrinsic Image Decomposition.

    PubMed

    Yue, Huanjing; Yang, Jingyu; Sun, Xiaoyan; Wu, Feng; Hou, Chunping

    2017-05-10

    In this paper, we propose to introduce intrinsic image decomposition priors into decomposition models for contrast enhancement. Since image decomposition is a highly ill-posed problem, we introduce constraints on both reflectance and illumination layers to yield a highly reliable solution. We regularize the reflectance layer to be piecewise constant by introducing a weighted `1 norm constraint on neighboring pixels according to the color similarity, so that the decomposed reflectance would not be affected much by the illumination information. The illumination layer is regularized by a piecewise smoothness constraint. The proposed model is effectively solved by the Split Bregman algorithm. Then, by adjusting the illumination layer, we obtain the enhancement result. To avoid potential color artifacts introduced by illumination adjusting and reduce computing complexity, the proposed decomposition model is performed on the value channel in HSV space. Experiment results demonstrate that the proposed method performs well for a wide variety of images, and achieves better or comparable subjective and objective quality compared with state-of-the-art methods.

  3. Color and power Doppler ultrasonography for characterization of splenic masses in dogs.

    PubMed

    Sharpley, Jenelle L; Marolf, Angela J; Reichle, Jean K; Bachand, Annette M; Randall, Elissa K

    2012-01-01

    Benign and malignant splenic masses can appear similar on B-mode imaging, making ultrasound sensitive but not specific in their diagnosis. Our goal was to characterize color and/or power Doppler characteristics of vasculature within and adjacent to a splenic mass, which would distinguish benign vs. malignant lesions. The hypothesis was that malignant splenic masses will have altered vascular patterns compared with benign masses. Color and power Doppler cineloops evaluating the vasculature within the mass and normal splenic parenchyma were obtained in sagittal and transverse planes using a standardized protocol. Categories of evaluation included presence of peritoneal effusion, a large aberrant or tortuous vessel within the mass, relative blood flow within the mass compared with normal parenchyma, and path of vessels in the adjacent parenchyma entering into the mass. All patients had histopathologic or definitive cytologic diagnosis. Thirty-one dogs were included. There were 13 malignant masses and 18 were benign. Peritoneal effusion was significantly associated with malignancy (P = 0.0007). Presence of an aberrant or tortuous vessel within the mass was nearly significant (P = 0.059). There was no significant difference in any of the color or power Doppler blood flow evaluations. Ultrasonographic findings of a splenic mass and peritoneal effusion may indicate malignancy. The presence of an aberrant vessel within a splenic mass could suggest malignancy; however more data are needed. © 2012 Veterinary Radiology & Ultrasound.

  4. DIAGNOSTIC AGREEMENT BETWEEN PANORAMIC RADIOGRAPHS AND COLOR DOPPLER IMAGES OF CAROTID ATHEROMA

    PubMed Central

    Romano-Sousa, Claudia Maria; Krejci, Laís; Medeiros, Flavilene Marchioro Martins; Graciosa, Ricardo Gomes; Martins, Maria Fernanda Fonseca; Guedes, Vanessa Novaes; Fenyo-Pereira, Marlene

    2009-01-01

    The aim of this study was to investigate the agreement between diagnoses of calcified atheroma seen on panoramic radiographs and color Doppler images. Our interest stems from the fact that panoramic images can show the presence of atheroma regardless of the level of obstruction detected by color Doppler images. Panoramic and color Doppler images of 16 patients obtained from the archives of the Health Department of the city of Valença, RJ, Brazil, were analyzed in this study. Both sides of each patient were observed on the images, with a total of 32 analyzed cervical regions. The level of agreement between diagnoses was analyzed using the Kappa statistics. There was a high level of agreement, with a Kappa value of 0.78. In conclusion, panoramic radiographs can help detecting calcifications in the cervical region of patients susceptible to vascular diseases predisposing to myocardial infarction and cerebrovascular accidents. If properly trained and informed, dentists can refer their patients to a physician for a cardiovascular evaluation in order to receive proper and timely medical treatment. PMID:19148405

  5. Color Doppler sonography of small bowel wall changes in 21 consecutive cases of acute mesenteric ischemia.

    PubMed

    Danse, E M; Kartheuser, A; Paterson, H M; Laterre, P-F

    2009-01-01

    To describe the small bowel wall changes observed with color Doppler sonography in acute mesenteric ischemia with comparison with its outcome. We reviewed the sonographic findings of 21 patients with a final diagnosis of acute mesenteric ischemia (12 acute arterial forms and 9 acute venous forms). These examinations included identification of non peristaltic thin-walled fluid-filled intestinal loops (with or without pneumatosis), thickened intestinal wall (> 3 mm) (noted as stratified or not), and preserved or absent mural flow assessed with color Doppler. Sonographic findings were compared with the surgical data (n = 16) or with the clinical outcome (n = 5). In acute arterial ischemia, non-peristaltic thin-walled intestinal loops were detected with sonography in five cases, with visualization of pneumatosis in one. Bowel infarction was diagnosed in four of these five patients including one patient with pneumatosis. Thickened bowel loops were sonographically detected in four cases, of which 3 required resection. Conservative therapy was performed in the remaining case having preserved wall stratification and mural flow with color Doppler. In acute venous ischemia, thickened bowel loops were detected with sonography in six cases. Conservative therapy was performed in three cases for whom preserved mural flow was noted. Stratification was present in two of these three cases. In acute arterial ischemia, intestinal resection is frequently required when non-peristaltic, thin-walled, fluid-filled loops are detected with sonography. In arterial and venous ischemia, absence of wall stratification and mural flow are frequently associated with ischemia requiring surgery.

  6. Color-Doppler ultrasound in the diagnosis of oral vascular anomalies.

    PubMed

    Gianfranco, Gaimari; Eloisa, Fioravanti; Vito, Cantisani; Raffaele, Guerrisi; Gianluca, Tenore; Umberto, Romeo

    2014-01-01

    In last few years, thanks to laser technology with minimally invasive approach, there was a growing need for treatment of oral vascular malformations inside the dental offices. Generally, the diagnosis of oral vascular malformations is based on clinical history, clinical examination and imaging exams. In the present paper, we review, researching by PubMed, the technical aspects, clinical indications, potentialities and limitations of color-Doppler ultrasound in the work-up of oral vascular malformations. Different imaging modalities are encountered for the diagnosis and follow-up of these lesions such as computed tomography, magnetic resonance imaging, color-Doppler ultrasound and angiography. To date, color-Doppler ultrasound is considered the first-line imaging approach since it provides a non-invasive, cost effective, real time evaluation of oral vascular anomalies. It provides both morphological and vascular information, which are useful to determine the best therapeutic options. Ultrasonography, for these reasons, could be considered as a valuable diagnostic tool in the preliminary assessment of oral vascular anomalies.

  7. Color-Doppler Ultrasound in the Diagnosis of Oral Vascular Anomalies

    PubMed Central

    Gianfranco, Gaimari; Eloisa, Fioravanti; Vito, Cantisani; Raffaele, Guerrisi; Gianluca, Tenore; Umberto, Romeo

    2014-01-01

    In last few years, thanks to laser technology with minimally invasive approach, there was a growing need for treatment of oral vascular malformations inside the dental offices. Generally, the diagnosis of oral vascular malformations is based on clinical history, clinical examination and imaging exams. In the present paper, we review, researching by PubMed, the technical aspects, clinical indications, potentialities and limitations of color-Doppler ultrasound in the work-up of oral vascular malformations. Different imaging modalities are encountered for the diagnosis and follow-up of these lesions such as computed tomography, magnetic resonance imaging, color-Doppler ultrasound and angiography. To date, color-Doppler ultrasound is considered the first-line imaging approach since it provides a non-invasive, cost effective, real time evaluation of oral vascular anomalies. It provides both morphological and vascular information, which are useful to determine the best therapeutic options. Ultrasonography, for these reasons, could be considered as a valuable diagnostic tool in the preliminary assessment of oral vascular anomalies. PMID:24678469

  8. Color Doppler Ultrasound Velocimetry Flow Reconstruction using Vorticity-Streamfunction Formulation

    NASA Astrophysics Data System (ADS)

    Meyers, Brett; Vlachos, Pavlos; Goergen, Craig; Scalo, Carlo

    2016-11-01

    Clinicians commonly utilize Color Doppler imaging to qualitatively assess the velocity in patient cardiac or arterial flows. However Color Doppler velocity are restricted to two-dimensional one-component measurements. Recently new methods have been proposed to reconstruct a two-component velocity field from such data. Vector Flow Mapping (VFM), in particular, utilizes the conservation of mass to reconstruct the flow. However, this method over-simplifies the influence of wall and surrounding blood motion on local measurements, which produce large, non-physical velocity gradients, requiring excessive smoothing operations to remove. We propose a new approach based on the Vorticity-Stream Function (Ψ- ω) formulation that yields more physiologically accurate velocity gradients and avoids any added smoothing operations. Zero-penetration conditions are specified at the walls, removing the need for measurement of wall velocity from additional scans, which introduce further uncertainties in the reconstruction. Inflow and outflow boundary conditions are incorporated by prescribing Dirichlet boundary conditions. The proposed solver is compared against the VFM using computational data to evaluate measurement improvement. Finally we demonstrate the method by evaluating murine left ventricle Color Doppler scans.

  9. Preoperative color Doppler ultrasound assessment of the lateral thoracic artery perforator flap and its branching pattern.

    PubMed

    Tashiro, Kensuke; Harima, Mitsunobu; Mito, Daisuke; Shibata, Takashi; Furuya, Megumi; Kato, Motoi; Yamamoto, Takumi; Yamashita, Shuji; Narushima, Mitsunaga; Iida, Takuya; Koshima, Isao

    2015-06-01

    The anatomy of the lateral thoracic artery perforator flap remains controversial, but this region is extremely useful as a reconstructive donor site. In this report, we describe the usefulness of the preoperative color Doppler ultrasound evaluation for the harvesting of the lateral thoracic artery perforator flap, and we clarify its branching pattern. Twenty-seven patients underwent the preoperative color Doppler ultrasound assessment before perforator flaps were harvested. We evaluated the branching pattern and the diameter of the flaps by direct observation. All flaps were successfully transferred, and it was found that the branching pattern of the lateral thoracic perforator is divided into three groups: the superficial branch, the medial branch, and the deep branch. Their appearance ratios were 48.1% (13/27), 14.8% (4/27), and 81.5% (22/27), respectively. The lateral thoracic artery perforator flap has a great deal of anatomical variation, and vessels with relatively small diameters compared to those of other flaps. This is why flaps from this region are not currently popular. This study revealed the superiority of the color Doppler ultrasound for preoperative planning of the lateral thoracic artery perforator flap elevation. Furthermore, the branching pattern and the diameters of the different branches were specified.

  10. Factors affecting color Doppler energy ultrasound recordings in an in-vitro model.

    PubMed

    Gudmundsson, S; Valentin, L; Pirhonen, J; Olofsson, P A; Dubiel, M; Marsal, K

    1998-07-01

    Compared to conventional color Doppler ultrasound imaging, the new color Doppler modality "color Doppler energy" (CDE) has improved the possibility of visualizing blood vessels having low blood-flow velocities, but appears to be influenced by the settings of the ultrasound instrument and motion artefacts. The aim of this methodological study was to evaluate the effects of the different factors on the CDE signal. The CDE mode of a commercially available ultrasound system (Acuson 128 XP) was tested in an in vitro study. The effect of depth, angle of insonation, flow velocity, instrument power output, gain and other instrument settings were evaluated. The CDE signals obtained were stored on videotape and subsequently subjected to off-line computer analysis. The CDE signal intensity was found to be influenced mainly by fluid flow velocity, but was also affected by depth and instrument settings. Gain and power had, however, limited influence in this setting. Thus, the intensity of the CDE signal is influenced by several factors. Our results emphasize the need for optimum fixed preinstalled instrument settings when attempting to quantify organ perfusion by use of this new technique.

  11. Diagnostic efficacy of color Doppler ultrasound in evaluation of cervical lymphadenopathy.

    PubMed

    Misra, Deepankar; Panjwani, Sapna; Rai, Shalu; Misra, Akansha; Prabhat, Mukul; Gupta, Prashant; Talukder, Subrata K

    2016-01-01

    To evaluate the efficacy of color Doppler ultrasound (CDUS) in differentiating benign and malignant cervical lymph nodes by detecting differences in blood flow patterns. In this cross-sectional prospective study, 25 untreated patients with clinical evidence of cervical lymphadenopathy were evaluated. CDUS was performed for 80 cervical lymph nodes. The gray scale parameters of the lymph node and intranodal perfusion sites were the key CDUS features used to differentiate between reactive and metastatic lymph nodes. Histopathological confirmations were obtained and compared with the results of CDUS. Initially, 53 cervical lymph nodes were evaluated by clinical examination. Twenty-seven additional lymph nodes (53 + 27 = 80) were discovered by CDUS evaluation. Gray scale parameters for lymph nodes such as size of lymph node, shape of lymph node, and presence or absence of hilum revealed highly significant results (P < 0.0001). Color Doppler flow signals revealed that central/hilar flow was characteristic for benign nodes whereas peripheral/mixed flow was characteristic for malignant nodes, the findings were highly significant (P < 0.0001). Gray scale and color Doppler features are used to differentiate benign and malignant nodes. Within the limitations of this study, CDUS evaluation was found to be highly significant with a high sensitivity and specificity over clinical evaluation CDUS examination provides a prospect to reduce the need for biopsy/fine needle aspiration cytology in reactive nodes.

  12. A Color-Doppler Shear-Wave-Imaging Phase-reconstruction Method Using Four Color Flow Images.

    PubMed

    Sunaguchi, Naoki; Yamakoshi, Yoshiki; Nakajima, Takahito

    2017-05-01

    This study investigates shear wave phase map reconstruction using a limited number of color flow images (CFIs) acquired with a color Doppler ultrasound imaging instrument. We propose an efficient reconstruction method to considerably reduce the number of CFIs required for reconstruction and compare this method with Fourier analysis-based color Doppler shear wave imaging. The proposed method uses a two-step phase reconstruction process, including an initial phase map derived from four CFIs using an advanced iterative algorithm of optical interferometry. The second step reduces phase artifacts in the initial phase map using an iterative correction procedure that cycles between the Fourier and inverse Fourier domains while imposing directional filtering and total variation regularization. We demonstrate the efficacy of this method using synthetic and experimental data of a breast phantom and human breast tissue. Our results show that the proposed method maintains image quality and reduces the number of CFIs required to four; previous methods have required at least 32 CFIs to achieve equivalent image quality. The proposed method is applicable to real-time shear wave elastography using a continuous shear wave produced by a mechanical vibrator.

  13. Contrast-enhanced endoscopic ultrasonography in digestive diseases.

    PubMed

    Hirooka, Yoshiki; Itoh, Akihiro; Kawashima, Hiroki; Ohno, Eizaburo; Itoh, Yuya; Nakamura, Yosuke; Hiramatsu, Takeshi; Sugimoto, Hiroyuki; Sumi, Hajime; Hayashi, Daijiro; Ohmiya, Naoki; Miyahara, Ryoji; Nakamura, Masanao; Funasaka, Kohei; Ishigami, Masatoshi; Katano, Yoshiaki; Goto, Hidemi

    2012-10-01

    Contrast-enhanced endoscopic ultrasonography (CE-EUS) was introduced in the early 1990s. The concept of the injection of carbon dioxide microbubbles into the hepatic artery as a contrast material (enhanced ultrasonography) led to "endoscopic ultrasonographic angiography". After the arrival of the first-generation contrast agent, high-frequency (12 MHz) EUS brought about the enhancement of EUS images in the diagnosis of pancreatico-biliary diseases, upper gastrointestinal (GI) cancer, and submucosal tumors. The electronic scanning endosonoscope with both radial and linear probes enabled the use of high-end ultrasound machines and depicted the enhancement of both color/power Doppler flow-based imaging and harmonic-based imaging using second-generation contrast agents. Many reports have described the usefulness of the differential diagnosis of pancreatic diseases and other abdominal lesions. Quantitative evaluation of CE-EUS images was an objective method of diagnosis using the time-intensity curve (TIC), but it was limited to the region of interest. Recently developed Inflow Time Mapping™ can be generated from stored clips and used to display the pattern of signal enhancement with time after injection, offering temporal difference of contrast agents and improved tumor characterization. On the other hand, three-dimensional CE-EUS images added new information to the literature, but lacked positional information. Three-dimensional CE-EUS with accurate positional information is awaited. To date, most reports have been related to pancreatic lesions or lymph nodes. Hemodynamic analysis might be of use for diseases in other organs: upper GI cancer diagnosis, submucosal tumors, and biliary disorders, and it might also provide functional information. Studies of CE-EUS in diseases in many other organs will increase in the near future.

  14. High resolution compression elastography and color doppler sonography in characterization of breast fibroadenoma.

    PubMed

    Rjosk-Dendorfer, D; Reu, S; Deak, Z; Hetterich, H; Kolben, T; Reiser, M; Clevert, D A

    2014-01-01

    To evaluate the use of color Doppler sonography and free hand sonoelastography in the assessment of breast fibroadenomas according to their size and shape. From December 2012 to March 2013 women with 16 solid breast masses, classified as BI-RADS category 3 or 4 were examined with B-mode ultrasound, sonoelastography and color Doppler sonography. Lesions were subdivided according to their shape in round, ovoid or macrolobulated and according to their size (<2.0 cm or ≥2.0 cm). Two readers assessed sonoelastographic findings at 12.5 MHz using the tsukuba elasticity score and results of Doppler sonography using a score of 0, 1 or 2, depending on the degree of perfusion. Among the 16 examined lesions 3 showed a round shape, 9 were ovoid and in 4 cases a macrolobulated appearance could be seen. No significant differences concerning Tsukuba-score depending on various shapes of fibroadenomas in B-mode sonography could be shown (p = 0.91) and also comparison of Tsukuba-scores and size of masses revealed no significant differences (p = 1.0). Sizes of fibroadenomas ≥2 cm were significantly associated with an increased vascularization of the lesions (p = 0.04) and a macrolobulated appearance in B-mode sonography (p = 0.04). The combination of color Doppler sonography and sonoelastography in addition to B-mode sonography leads to an increased accuracy in distinguishing benign from malignant breast masses and to an improvement in characterization of fibroadenomas independent of their shape or size.

  15. Planning digital artery perforators using color Doppler ultrasonography: A preliminary report.

    PubMed

    Shintani, Kosuke; Takamatsu, Kiyohito; Uemura, Takuya; Onode, Ema; Okada, Mitsuhiro; Kazuki, Kenichi; Nakamura, Hiroaki

    2016-05-01

    Digital artery perforator (DAP) flaps have been applied for the coverage of finger soft tissue defects. Although an advantage of this method is that there is no scarification of the digital arteries, it is difficult to identify the location of the perforators during intraoperative elevation of the DAP flap. In this study, anatomically reliable locations of DAPs were confirmed using color Doppler ultrasonography (US) in healthy volunteers. A successful case using an adiposal-only DAP flap for the coverage of a released digital nerve using preoperative DAP mapping with color Doppler US is also described. A total of 40 digital arteries in 20 fingers of the right hands of five healthy volunteers (mean age: 32.2 years old) were evaluated. The DAPs were identified using color flow imaging based on the beat of the digital artery in the short axial view. In total, 133 perforators were detected, 76 (an average of 3.8 per finger) arising from the radial digital artery and 57 (an average of 2.9 per finger) arising from ulnar digital artery. Sixty-three perforators (an average of 3.2 per finger) in the middle phalanges and 70 (an average of 3.5 per finger) in the proximal phalanges were found. Overall, an average of 1.7 perforators from each digital artery was detected in the proximal or middle phalanges. Moreover, at least one DAP per phalanx was reliably confirmed using color Doppler US. Preoperative knowledge of DAP mapping could make elevating the DAP flap easier and safer.

  16. Cow's milk allergy: color Doppler ultrasound findings in infants with hematochezia.

    PubMed

    Epifanio, Matias; Spolidoro, Jose Vicente; Missima, Nathalia Guarienti; Soder, Ricardo Bernardi; Garcia, Pedro Celiny Ramos; Baldisserotto, Matteo

    2013-01-01

    ultrasound (US) has been an important diagnostic tool to identify several causes of gastrointestinal bleeding. Infants with cow's milk allergy (CMA) may present hematochezia and the confirmation of the diagnosis can be difficult. The aim of this study is to describe grayscale and color Doppler ultrasound findings in patients with CMA. we retrospectively studied 13 infants with CMA. All infants presented severe hematochezia and abdominal pain. All underwent an US study with the diagnosis of allergic colitis. This diagnosis was based on clinical findings, recovery after infant or mother exclusion diets in the case of exclusive breastfeeding and positive oral challenge test. the mean age ranged from 1 to 6 months (mean=3.53). Seven out of 13 infants (53.8%) had grayscale and color Doppler sonographic repeated after exclusion diet. Twelve out of 13 (92,3%) showed abnormalities at US and CDUS at beginning. The positive findings suggesting colitis were thickened bowel walls and increased vascularity, especially in the descending and sigmoid colon. Colonoscopy and histopathological findings were compatible with allergic colitis. After a diet change the 13 infants recovered and their oral challenge tests were positive. Doppler US may be very useful in diagnosing secondary colitis, such as CMA, and to exclude several other abdominal diseases that can emulate this disease. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  17. [Evaluation of color Doppler imaging of ophthalmic tumors based on histopathologic findings].

    PubMed

    Németh, János; Tapasztó, Beáta; Tóth, Jeannette; Harkányi, Zoltán

    2005-01-01

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

  18. B-mode Ultrasound Versus Color Doppler Twinkling Artifact in Detecting Kidney Stones

    PubMed Central

    Harper, Jonathan D.; Hsi, Ryan S.; Shah, Anup R.; Dighe, Manjiri K.; Carter, Stephen J.; Moshiri, Mariam; Paun, Marla; Lu, Wei; Bailey, Michael R.

    2013-01-01

    Abstract Purpose To compare color Doppler twinkling artifact and B-mode ultrasonography in detecting kidney stones. Patients and Methods Nine patients with recent CT scans prospectively underwent B-mode and twinkling artifact color Doppler ultrasonography on a commercial ultrasound machine. Video segments of the upper pole, interpolar area, and lower pole were created, randomized, and independently reviewed by three radiologists. Receiver operator characteristics were determined. Results There were 32 stones in 18 kidneys with a mean stone size of 8.9±7.5 mm. B-mode ultrasonography had 71% sensitivity, 48% specificity, 52% positive predictive value, and 68% negative predictive value, while twinkling artifact Doppler ultrasonography had 56% sensitivity, 74% specificity, 62% positive predictive value, and 68% negative predictive value. Conclusions When used alone, B-mode is more sensitive, but twinkling artifact is more specific in detecting kidney stones. This information may help users employ twinkling and B-mode to identify stones and developers to improve signal processing to harness the fundamental acoustic differences to ultimately improve stone detection. PMID:23067207

  19. [The role of arms color Doppler before creation arteriovenous fistula for hemodialysis].

    PubMed

    Varlaj-Knobloch, Vesna; Krnić, Anton; Orsanić-Brcić, Dubravka; Marinković, Davor

    2008-01-01

    our experience with color Doppler of arms blood vessels before creation arteriovenous fistula for hemodialysis. three years ago all patients who need surgery creation of arteriovenous fistula had Doppler ultrasound preoperative vascular mapping. Purpose of the view is to take a picture of proximal and distal part of arteria radials both arms, distal part of venous cephalica and proximal part of venous mediana antebrachii. We must know if these blood vessels have good morphological and hemodinamic criteria for creation arteiovenous fistula. in the study were twenty patients, creation of AV fistula was unsuccessful by two patients, but ultrasonic doctor had warning on very gracile blood vessels; by 18 patients in period of 2 to 36 months (mean 12.2 moths) we have optimal effective flow through dialysis filter 300 ml/min, and they are still in good function. carefully blood vessels review with color Doppler before creation arteriovenous fistula for hemodialysis, and marking suitable blood vessels with marker on the skin under sonography control reduced unsuccessful number of surgery exploration and destruction of blood vessels if AV fistula don't work. This is very important for hemodialysis patients, especially for diabetics.

  20. Palliative treatment of hepatocellular carcinoma with percutaneous ethanol injection using tumor's feeding artery occlusion under the ultrasonic color Doppler guidance.

    PubMed

    Rustemović, Nadan; Vucelić, Boris; Opacić, Milorad; Ostojić, Rajko; Pulanić, Roland; Petrovecki, Mladen; Radanović, Branko; Marinić, Jasna; Pulanić, Drazen

    2004-12-01

    We evaluate the efficacy of PEIT in patients with HCC using duplex color Doppler US. The study included 27 HCC patients admitted to the University Hospital Centre Zagreb, between 1993 and 1997. PEIT was performed for ablation of tumor supplying vessels in HCCs of < 5 cm in diameter, and as a palliative measure for tumor feeding vessel obliteration in larger tumors. The efficacy of PEIT was evaluated with duplex color Doppler US, and controlled by dynamic CT scan (16 patients) or selective angiography of hepatic artery (11 patients). All patients had well vascularized tumors before PEIT, and after therapy 25 of them showed absent or minimal tumor vascularization. Recanalization of the tumor feeding vessel was detected with Doppler US within 9 months after therapy. Study results suggested that duplex color Doppler US should be the method of choice in the evaluation of PEIT as well as in the follow-up of HCC patients after PEIT.

  1. Contrast-enhanced B-mode US angiography in the assessment of experimental in vivo and in vitro atherosclerotic disease.

    PubMed

    Sirlin, C B; Lee, Y Z; Girard, M S; Peterson, T M; Steinbach, G C; Baker, K G; Mattrey, R F

    2001-02-01

    This study was performed to (a) test the hypothesis that filling the arterial lumen with echoes at B-mode ultrasound (US) enables the assessment of wall and luminal abnormalities and (b) compare contrast material-enhanced B-mode US with color and power Doppler US angiography. Atherosclerotic lesions were created in 14 rabbit aortas and imaged with color Doppler and B-mode US before and after the intravenous administration of 0.3 mL of AF0150, a US contrast agent. In addition, four replicas of diseased human carotid arteries were immersed in a tissue-mimicking phantom and imaged with B-mode and color and power Doppler US before and after the administration of 1 mL of AF0150 per liter of porcine blood. Radiopaque plastic casts of the rabbit aortas and contact radiographs of the plastic replicas served as standards. Although color and power Doppler US allowed immediate localization of the lumen, precise estimation of stenoses and reliable visualization of surface irregularities were not possible. After AF0150 administration, angiogram-like images of the lumen were created with B-mode US, allowing rapid assessment of the entire vessel lumen and wall. Consequently, luminal stenoses were more accurately measured than with unenhanced B-mode US (r2 = 0.94, P < .0001 vs r2 = 0.21, P = .25) or Doppler (r2 = 0.42, P < .03). In addition, plaques and ulcerations were visible only with contrast-enhanced B-mode US. Microbubbles fill the arterial lumen with echoes at B-mode US, creating an angiogram-like image. The ability to visualize the inner and outer surfaces of the vascular wall improved the evaluation of luminal and wall abnormalities.

  2. Contrast-enhanced harmonic endoscopic ultrasonography for assessment of lymph node metastases in pancreatobiliary carcinoma

    PubMed Central

    Miyata, Takeshi; Kitano, Masayuki; Omoto, Shunsuke; Kadosaka, Kumpei; Kamata, Ken; Imai, Hajime; Sakamoto, Hiroki; Nisida, Naoshi; Harwani, Yogesh; Murakami, Takamichi; Takeyama, Yoshifumi; Chiba, Yasutaka; Kudo, Masatoshi

    2016-01-01

    AIM: To assess the usefulness of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for lymph node metastasis in pancreatobiliary carcinoma. METHODS: All patients suspected of pancreatobiliary carcinoma with visible lymph nodes after standard EUS between June, 2009 and January, 2012 were enrolled. In the primary analysis, patients with successful EUS-fine needle aspiration (FNA) were included. The lymph nodes were assessed by several standard EUS variables (short and long axis lengths, shape, edge characteristic and echogenicity), color Doppler EUS variable [central intranodal blood vessel (CIV) presence] and CH-EUS variable (heterogeneous/homogeneous enhancement patterns). The diagnostic accuracy relative to EUS-FNA was calculated. In the second analysis, N-stage diagnostic accuracy of CH-EUS was compared with EUS-FNA in patients who underwent surgical resection. RESULTS: One hundred and nine patients (143 lymph nodes) fulfilled the criteria. The short axis cut-off ≥ 13 mm predicted malignancy with a sensitivity and specificity of 72% and 85%, respectively. These values were 72% and 63% for the long axis cut-off ≥ 20 mm, 62% and 75% for the round shape variable, 81% and 30% for the sharp edge variable, 66% and 61% for the hypoechogenicity variable, 70% and 72% for the CIV-absent variable, and 83% and 91% for the heterogeneous CH-EUS-enhancement variable, respectively. CH-EUS was more accurate than standard and color Doppler EUS, except the short axis cut-off. Notably, three patients excluded because of EUS-FNA failure were correctly N-staged by CH-EUS. CONCLUSION: CH-EUS complements standard and color Doppler EUS and EUS-FNA for assessment of lymph node metastases. PMID:27022220

  3. Dynamic Contrast-Enhanced Digital Breast Tomosynthesis

    DTIC Science & Technology

    2012-03-01

    11-1-0229 TITLE: Dynamic Contrast-Enhanced Digital Breast Tomosynthesis PRINCIPAL INVESTIGATOR: Dr. Andrew Maidment...5 Introduction We propose a new technique for obtaining 4D dynamic contrast-enhanced (DCE) digital breast tomosynthesis (DBT) im...seconds. One com plete tomosynthesis projection series consists of a set of projection im ages acquired at distinct angles. In the proposed m ethod

  4. Color Doppler energy--a new technique to study tissue perfusion in renal transplants.

    PubMed

    Hoyer, P F; Schmid, R; Wünsch, L; Vester, U

    1999-09-01

    Information on renal tissue perfusion after transplantation remains important for renal allograft monitoring. Findings obtained by conventional Doppler sonography are limited to vascular resistance (RI). The new technique color Doppler energy (CDE) is Doppler angle independent, omits flow velocity and direction, and is proportional to the returning signal strength. The aim of our study was to standardize the application of this technique and to analyze the information obtained. Forty-six CDE studies were performed with an Acuson 128XP in 28 children (mean age 12.4+/-5.3 years) between 4 days and 10 years after renal transplantation. The most-reproducible information was obtained with a 5-MHz linear probe and a constant area of 2x3 cm (log compression 40 dB, filter 3). CDE provided a high-resolution cross-sectional display of perfused cortical tissue vessels. According to the density of signals, the perfusion could be grouped into six perfusion scores (PS). The interobserver concordance was more than 85%. No correlation was found between PS and RI or blood pressure. However, there was a significant correlation between PS and glomerular filtration rate (r=-0.78, P<0. 001). These first results demonstrate a significant relationship between PS and chronic rejection. Non-rejection-related functional impairment exhibited no decrease in PS. We conclude that our proposed standardized CDE renal study is observer independent. CDE is a promising new technique that provides information on renal allograft dysfunction that is different from classical color Doppler findings. Further studies will clarify its role in renal transplant monitoring and its ability to replace more-invasive techniques.

  5. Combination of high-resolution and color Doppler ultrasound in diagnosis of carpal tunnel syndrome.

    PubMed

    Ghasemi-Esfe, Ahmad Reza; Khalilzadeh, Omid; Mazloumi, Mehdi; Vaziri-Bozorg, Seyed Mehran; Niri, Sanaz Ghaderi; Kahnouji, Hossein; Rahmani, Maryam

    2011-03-01

    Ultrasound has recently emerged as a diagnostic tool in carpal tunnel syndrome (CTS). To evaluate the utility of a combination of high-resolution and color Doppler ultrasound as an alternative to electrodiagnostic tests (EDT), in CTS diagnosis, and to define an ultrasonographic prediction model for CTS. A total of 85 patients with certain clinical diagnosis of CTS and 49 healthy controls were enrolled. High-resolution and color Doppler ultrasound were performed and the cross-sectional area (CSA), hypoechogenicity, and hypervascularity of the median nerve were evaluated. Receiver-operating characteristic curves were used to determine the optimal cut-off point of median nerve CSA in diagnosis of CTS. Multivariate logistic regression analysis was used to formulate a prediction model for CTS. The optimal cut-off point of median CSA in wrist was 10.5 mm(2). Hypervascularity (OR = 37.95), hypoechogenicity (OR = 12.30), and high CSA (OR = 34.79) of median nerve were significantly (P < 0.001) higher in CTS patients than in controls. No significant difference was found between the sensitivity and specificity of EDT and any of the above indices in prediction of CTS. An ultrasonographic model for prediction of CTS, comprised hypervascularity and/or high CSA of median nerve, could predict the CTS probability between 87-99%. The sensitivity and specificity of this model (86% and 84%) was not different from EDT (80% and 84%). A combination of high-resolution and color Doppler ultrasound can be used as a non-invasive alternative to EDT in diagnosis of CTS.

  6. Color Doppler provides a reliable and rapid means of monitoring luteolysis in female donkeys.

    PubMed

    Miró, J; Vilés, K; Anglada, O; Marín, H; Jordana, J; Crisci, A

    2015-03-01

    When artificial reproduction technologies designed for use with horses are used with donkeys, success is dependent on awareness of the physiological differences between these species, yet little information is available on many aspects of donkey reproduction. The present work examines the activity of the CL in Catalonian jennies after induced luteolysis. Plasma progesterone concentration, luteal blood flow (determined by color Doppler), and CL cross-sectional area (CL-CSA; determined by B-mode ultrasound examination) were assessed after a single dose (5 mg intramuscular) of dinoprost thromethamine (DT, a PGF2α analog) on Day 10 after ovulation in two experiments. In experiment 1, a preliminary experiment, data were collected daily for 4 days after DT administration. Values for all the measured variables decreased over this period. In experiment 2, data were collected during the first 24 hours after DT administration because in experiment 1, most luteolytic activity occurred during this time. An increase in luteal blood flow was seen between 0 and 3 hours, followed by a progressive reduction, whereas the values for plasma progesterone and CL-CSA gradually decreased from 0 hours onward. In both studies, negative correlations were seen between all variables and the time of sampling. In contrast, positive correlations were seen between plasma progesterone, CL-CSA, uterine tone, and luteal blood flow. Indeed, a strong correlation was recorded between plasma progesterone and luteal blood flow (r = 0.70; P < 0.0001). In conclusion, plasma progesterone and CL-CSA both become reduced after induced luteolysis in Catalonian jennies. Unlike in mares, an increase in luteal blood flow occurs soon after induced luteolysis, rather like that seen in the cow. The luteal blood flow, as evaluated here by color Doppler, was also closely related to the plasma progesterone concentration. Color Doppler would appear therefore to offer a rapid and easy means of examining the state

  7. [The color Doppler US evaluation of the ureteral jet in patients with urinary colic].

    PubMed

    Catalano, O; De Sena, G; Nunziata, A

    1998-06-01

    To report our personal experience with color Doppler ultrasound (US) in the study of the ureterovesical jet in patients with recent renal colic. First, the jet was studied in 10 healthy subjects and then 42 consecutive patients with urinary colic were submitted to plain radiography, which was sometimes integrated with conventional renal tomography, and real time US to detect the stone and to study the urinary tract above. Then, color Doppler function studies were carried out with transverse scans at the trigone and with the scan plane rotated on the ureterovesical junction. Retrospectively, the jet frequency, velocity, duration, volume, direction and interval were analyzed. Finally, all patients were examined with excretory urography. The jet had an anteromedial direction and exceeded the midline in the controls, with a peak velocity of 20-30 cm/s, mean duration of 15 s, mean frequency of 4-5 min and interjet interval 2-150 s. The jet was abnormal in the obstruction side in all renal colic patients; it was slow, continuous, decreased in volume and intensity, and prolonged in 26 patients--20 of them had incomplete lumbo-iliac ureteral obstruction and 6 pyeloureteral junction stones. The jet was diverted from its orientation in 7 subjects with intramural stones. There was no jet in 9 patients and urography demonstrated complete urinary obstruction--4 at the pyeloureteral junction and 5 at the lumbo-iliac ureter. Color Doppler US of the ureteral jet is a valuable tool in urinary colics because it yields in real time more pieces of functional information than radiography and B-mode US and also demonstrates the grade of urinary obstruction.

  8. Noninvasive color Doppler sonography of uterine blood flow throughout pregnancy in sheep and goats.

    PubMed

    Elmetwally, M; Rohn, K; Meinecke-Tillmann, S

    2016-04-01

    In contrast to cattle or horses, uterine blood flow in small ruminants has been investigated predominantly after surgical intervention and chronic instrumentation. The objective of the present study was to investigate the clinical applicability of noninvasive color Doppler sonography to characterize blood flow in the maternal uterine artery of sheep, n = 11 (18 pregnancies) and goats, n = 11 (20 pregnancies). The following parameters were measured transrectally or transabdominally: blood flow volume, time-averaged maximum velocity (TAMV), resistance index (RI), pulsatility index (PI), Time-averaged mean velocity, impedance of blood flow (AB or systolic/diastolic [S/D] velocity ratio), peak velocity of blood flow and blood flow acceleration. Examinations started 2 weeks after breeding and continued at 2-week intervals until parturition. Outcomes for sheep and goats were similar and will be discussed together. Based on noninvasive color Doppler sonography, blood flow volume increased (approximately 60-fold, P < 0.0001) until the end of pregnancy, with a rapid increase early in gestation, and a slow increase after week 18. Time-averaged maximum velocity in the uterine artery increased (approximately 4-fold; P < 0.0001) throughout pregnancy in sheep and goats. Furthermore, for uterine artery blood flow, there was an effect of stage of pregnancy on PI and RI (P < 0.001 and P < 0.0001, respectively), both indices decreased until the end of gestation. Time-averaged mean velocity decreased from week 18 to 20 in both species. The blood flow acceleration increased (P < 0.0001) until week 16 and week 14 in sheep and goats, respectively, and then decreased until parturition. Similar to PI and RI, vascular impedance of the uterine decreased (P < 0.0001) throughout pregnancy. This is apparently the first study using noninvasive color Doppler sonography of uterine blood flow throughout physiological pregnancy in small ruminants. Clearly, this technology facilitates repeated

  9. Diagnosis, treatment and application of color Doppler in conservative management of abnormally adherent placenta.

    PubMed

    Merz, W; Van de Vondel, P; Strunk, H; Geipel, A; Gembruch, U

    2009-12-01

    Placenta ac-, in-, percreta is rare, but associated with high maternal morbidity. We report the results of diagnosis and management of patients with this condition at our institution. Serial color Doppler examinations were performed to investigate the pattern and duration of perfusion to abnormally adherent placenta after conservative treatment. The influence of these results on management decisions was evaluated. Women with placenta ac-, in-, percreta delivering within a three-year interval were included. Diagnosis was established by ultrasound, color Doppler, MRI, and histology specimen. B-mode ultrasound and color Doppler were applied post-operatively. Fifteen cases of placenta ac-, in-, percreta occurred (0.29% of deliveries). 73.3% were associated with placenta previa, 66.6% had > or = 1 previous uterine surgery. Abnormal placentation was diagnosed antenatally in 5/15 cases; in these women complication rate (0/5 vs. 8/10, p = 0.12) and blood loss was significantly lower (mean 1.140 vs. 3.080 ml, p < 0.01). 8/15 women underwent Cesarean hysterectomy, 2 after embolization of uterine arteries. 7/15 women had conservative management. In 3 of these cases complete removal of the placenta was achieved; in the remaining 4 the entire (n = 2) or parts (n = 2) of the placenta were left in place, methotrexate was administered postoperatively, and close clinical and laboratory controls were performed. Serial color Doppler examinations revealed cessation of blood flow to the adherent tissue 9 - 13 weeks postoperatively, followed by complete resorption (n = 1)/expulsion (n = 1) of placental fragments. In two cases (placenta previa percreta) curettage was performed without major complications after negative blood flow. The high maternal morbidity of placenta ac-, in-, percreta can be reduced with antenatal diagnosis and elective delivery. Conservative management of placenta percreta may be considered in selected cases, with embolization and/or methotrexate as an adjuvant

  10. Validation of portal vein flow measurement by color flow Doppler sonography in a porcine model of septic shock.

    PubMed

    Zülke, Carl; Matejovic, Martin; Träger, Karl; Radermacher, Peter

    2005-09-01

    To compare portal vein flow values gained by color flow Doppler sonography with simultaneously derived data from an ultrasound transit time flow probe. Repeated, simultaneous flow measurements were performed in a prospective study investigating the effect of various drugs on hepatosplanchnic perfusion and energy balance in a long-term model of stable, hyperdynamic endotoxin shock. Investigational animal laboratory. Domestic pigs. Alterations in respirator setting were studied with regard to their effect on the quality of color flow Doppler data in comparison to flow probe data. Additional experiments included variation in PEEP level in conjunction with volume resuscitation. Respiratory rates of 14-18/min led to color Doppler flow values consistently 20-40% above simultaneously measured flow probe data. Temporary apnea led to enhanced agreement of data. Reduction in respiratory rate to 8/min with increase in tidal volume consistently led to color Doppler data within 10% of the corresponding flow probe values. A short-term period of respirator-dependent, constant portal vein inflow enables color Doppler sonography to detect correct values in a clinically relevant setting of hyperdynamic endotoxin shock.

  11. MR angiography versus color Doppler sonography in the evaluation of renal vessels and the inferior vena cava in abdominal masses of pediatric patients.

    PubMed

    Pfluger, T; Czekalla, R; Hundt, C; Schubert, M; Graubner, U; Leinsinger, G; Scheck, R; Hahn, K

    1999-07-01

    Involvement of renal vessels and the inferior vena cava (IVC) plays a decisive role during operative planning for removal of abdominal masses in pediatric patients. Advantages and limitations of MR angiography and color Doppler sonography for determining these factors were evaluated. MR angiography and color Doppler sonography were performed preoperatively in 42 neonates, infants, and children with abdominal masses and were compared with spin-echo MR imaging and with surgical findings. Variables evaluated were anatomic variants, vessel displacement, patency of vessels, collateral circulation, and intravascular tumor extension. Quality of vessel visualization was assessed in vessels not affected by tumor. In 88% of unaffected renal vessels, the entire vessel course could be visualized on MR angiography compared with 58% on color Doppler sonography and 43% on spin-echo MR imaging. In four of nine cases, color Doppler sonography revealed an accessory renal artery, whereas MR angiography revealed these variants in seven of nine cases. MR angiography showed 79% and color Doppler sonography 66% of displaced vessels. Unlike MR angiography, color Doppler sonography did not reveal five stenotic renal veins because they could not be completely imaged. In two cases, however, MR angiography falsely indicated an occlusion of the IVC, whereas color Doppler sonography showed residual flow. Anatomic variants, vessel displacement, collateral circulation, and neoplastic vessel infiltration were revealed more accurately by MR angiography than by color Doppler sonography. In cases in which patency of the IVC is unclear on MR angiography, color Doppler sonography should also be performed.

  12. Technology Insight: the role of color and power Doppler ultrasonography in rheumatology.

    PubMed

    Schmidt, Wolfgang A

    2007-01-01

    An increasing number of rheumatologists have access to ultrasound equipment that provide both color and power Doppler modes, which can be used to investigate musculoskeletal and vascular pathologies. Musculoskeletal Doppler ultrasonography can be used to estimate levels of inflammation, to document the anti-inflammatory effect of agents such as corticosteroids and tumor necrosis factor inhibitors, to differentiate between inflammatory and degenerative disease, and to distinguish between normal and inflamed joints in cases of minor synovial swelling. Vascular Doppler ultrasonography can be used to determine organ involvement in small-vessel vasculitides, to delineate aneurysms in vasculitides of medium-sized arteries, and to assess the characteristic findings in large-vessel vasculitis. Numerous studies, including a meta-analysis, have been published on the use of temporal-artery ultrasonography for the diagnosis of giant cell arteritis. Duplex ultrasonography is a sensitive approach for detecting characteristic edematous wall swellings in active temporal arteritis and for assessing vasculitis of the axillary arteries (large-vessel giant cell arteritis) in patients with suspected temporal arteritis, polymyalgia rheumatica, or fever of unknown origin. Duplex ultrasonography can also be used to assess vasculitis of subclavian and carotid arteries in younger patients with Takayasu's arteritis and acute finger artery occlusions in patients with small-vessel vasculitides.

  13. [Duplex ultrasound and color-coded Doppler ultrasound of visceral blood vessels in abdominal diseases].

    PubMed

    Mostbeck, G; Mallek, R; Gebauer, A; Tscholakoff, D

    1992-01-01

    Duplex Doppler sonography (DS) and color-flow Doppler sonography (FDS) are noninvasive diagnostic methods for the evaluation of a patient with suspected vascular disease of the abdomen. They represent a useful adjunct to realtime sonography in the identification of normal and variant visceral vascular anatomy. Aneurysms and pseudo-aneurysms of visceral arteries are readily differentiated from other cystic lesions. DS and FDS have a high sensitivity in the detection of portal vein thrombosis and stenosis. Both methods allow the observation and measurement of splanchnic hemodynamics in patients with chronic liver disease and portal hypertension. Hence, DS and FDS already play an important role in the pre- and postoperative assessment of patients undergoing liver or pancreas transplantation. The possibility that DS and FDS may enable discrimination between hypovascular and hypervascular tumors is under clinical investigation. FDS facilitates an excellent anatomic display of the abdominal vasculature and allows easy placement of the Doppler sample volume. Consequently, quantitative data acquired with DS are accomplished within short scanning times. However, the diagnostic impact of both modalities depends to a great extent on the experience of the investigator.

  14. Prevalence in a volunteer population of pelvic cancer detected with transvaginal ultrasound and color flow Doppler.

    PubMed

    Schulman, H; Conway, C; Zalud, I; Farmakides, G; Haley, J; Cassata, M

    1994-09-01

    Our objective was to find the prevalence of non-symptomatic endometrial and ovarian neoplasms in a volunteer population of women, aged 40 and over. We offered a free volunteer screening program to asymptomatic women for a study using transvaginal ultrasound and color flow Doppler for the detection of pelvic cancer. In the first 2 years, 2117 women were examined, 51.3% post-menopausal. An ovarian cyst was defined as having a maximum diameter of more than 2.4 cm. Color flow was used to identify blood vessels feeding pelvic organs and adnexal enlargements. An abnormal Doppler flow velocity for the ovary was defined as a resistance index of less than 0.41. Ovarian cysts of less than 5 cm with normal Doppler indices were followed up in 6 months to 1 year. An adnexal morphology score was created to quantify the usefulness of this parameter, particularly in postmenopausal women. Indications for surgery were pre-defined as a persistent ovarian cyst of more than 5 cm, a persistent suspicious Doppler and a total endometrial thickness of greater than 0.59 cm in postmenopausal women not taking hormones.A total of 202 women (9.5%) had ovarian cysts. Fourteen women were operated upon because of size criteria, one because of family history and three for persistent abnormal flow. By Doppler study, 15 cysts were predicted to be benign and histology was confirmatory. There were two false positives and one true positive, a stage Ib ovarian cancer. There were no false negatives, although a stage I endometrioid cancer of the ovary was detected 8 months after a negative scan. In those cases in which follow-up data were available, 56% of the cysts regressed in premenopausal women. In postmenopausal women, 28% regressed. Twenty of 1086 postmenopausal women had endometrial biopsies. Three had endometrial cancer, two stage I and one stage IIA. Five had atypical or adenomatous hyperplasia, and seven had benign polyps. So many women have small asymptomatic cysts of the ovary that a major

  15. New adaptive clutter rejection for ultrasound color Doppler imaging: in vivo study.

    PubMed

    Yoo, Yang Mo; Kim, Yongmin

    2010-03-01

    Clutter rejection is essential for accurate flow estimation in ultrasound color Doppler imaging. In this article, we present a new adaptive clutter rejection (ACR) technique where an optimum filter is dynamically selected depending upon the underlying clutter characteristics (e.g., tissue acceleration and power). We compared the performance of the ACR method with other adaptive methods, i.e., down-mixing (DM) and adaptive clutter filtering (ACF), using in vivo data acquired from the kidney, liver and common carotid artery. With the kidney data, the ACR method provided an average improvement of 3.05 dB and 1.7 dB in flow signal-to-clutter ratio (SCR) compared with DM and ACF, respectively. With the liver data, SCR was improved by 2.75 dB and 1.8 dB over DM and ACF while no significant improvement with ACR was found in the common carotid artery data. Thus, the proposed adaptive method could provide more accurate flow estimation by improving clutter rejection in abdominal ultrasound color Doppler imaging pending validation.

  16. Vascular waveform analysis of flap-feeding vessels using color Doppler ultrasonography.

    PubMed

    Ogino, Akihiro; Onishi, Kiyoshi

    2014-01-01

    We performed vascular waveform analysis of flap-feeding vessels using color Doppler ultrasonography and evaluated the blood flow in the flaps prior to surgery. Vascular waveform analysis was performed in 19 patients. The analyzed parameters included the vascular diameter, flow volume, flow velocity, resistance index, pulsatility index, and acceleration time. The arterial waveform was classified into 5 types based on the partially modified blood flow waveform classification reported by Hirai et al.; in particular, D-1a, D-1b, and D-2 were considered as normal waveforms. They were 4 patients which observed abnormal vascular waveform among 19 patients (D-4 : 1, D-3 : 1, and Poor detect : 2). The case which presented D-4 waveform changed the surgical procedure, and a favorable outcome was achieved. Muscle flap of the case which presented D-3 waveform was partially necrosed. The case which detected blood flow poorly was judged to be the vascular obstruction of the internal thoracic artery. In the evaluation of blood flow in flaps using color Doppler ultrasonography, determination of not only basic blood flow information, such as the vascular distribution and diameter and flow velocity, but also the flow volume, vascular resistance, and arterial waveform is essential to elucidate the hemodynamics of the flap.

  17. Enhanced sensitivity in H photofragment detection by two-color reduced-Doppler ion imaging

    NASA Astrophysics Data System (ADS)

    Epshtein, Michael; Portnov, Alexander; Kupfer, Rotem; Rosenwaks, Salman; Bar, Ilana

    2013-11-01

    Two-color reduced-Doppler (TCRD) and one-color velocity map imaging (VMI) were used for probing H atom photofragments resulting from the ˜243.1 nm photodissociation of pyrrole. The velocity components of the H photofragments were probed by employing two counterpropagating beams at close and fixed wavelengths of 243.15 and 243.12 nm in TCRD and a single beam at ˜243.1 nm, scanned across the Doppler profile in VMI. The TCRD imaging enabled probing of the entire velocity distribution in a single pulse, resulting in enhanced ionization efficiency, as well as improved sensitivity and signal-to-noise ratio. These advantages were utilized for studying the pyrrole photodissociation at ˜243.1 and 225 nm, where the latter wavelength provided only a slight increase in the H yield over the self-signal from the probe beams. The TCRD imaging enabled obtaining high quality H+ images, even for the low H photofragment yields formed in the 225 nm photolysis process, and allowed determining the velocity distributions and anisotropy parameters and getting insight into pyrrole photodissociation.

  18. Application of high frequency color Doppler ultrasound in the monitoring of rheumatoid arthritis treatment

    PubMed Central

    ZHENG, GUIMIN; WANG, LEI; JIA, XIUCHUAN; LI, FANG; YAN, YONGLONG; YU, ZHIBO; LI, LI; WEI, QUN; ZHANG, FENGXIAO

    2014-01-01

    The aim of the present study was to explore the use of high frequency color Doppler ultrasound to measure synovial thickness and blood flow to assess the therapeutic value of the recombinant human tumor necrosis factor (TNF) II receptor antibody fusion protein in rheumatoid arthritis (RA) treatment. A total of 36 clinically-diagnosed patients with RA were treated with methotrexate tablets or the recombinant TNF-receptor antibody fusion protein for 24 weeks. Joint synovial thickness and synovial blood flow integrity were monitored by high frequency color Doppler in the second metacarpophalangeal joint in one hand. The correlation of the erythrocyte sedimentation rate, C-reactive protein (CRP) and 28-joint disease activity score (DAS28) with the ultrasound parameters were analyzed. Metacarpophalangeal second joint 2 (MCP2) synovial thickness, wrist joint synovial thickness and MCP2 synovial blood flow, prior and subsequent to the treatment, have a high correlation with DAS28 (P<0.05), and the MCP2 synovial blood flow integral has a strong correlation with CRP. Evaluating the wrist joint synovial thickness and synovial integrity of the second metacarpophalangeal joint using high frequency ultrasound detection can effectively evaluate the disease status in patients with RA. This procedure is potentially valuable as a means of evaluating the curative effects of RA treatments. PMID:25371736

  19. The value of high-frequency and color Doppler ultrasonography in diagnosing congenital muscular torticollis

    PubMed Central

    2012-01-01

    Background Congenital muscular torticollis (CMT) is a relatively common neck deformity in infancy. The aim of our research was to determine the value of high-frequency and color Doppler ultrasonography in diagnosing CMT. Methods Patients with a clinical suspicion of CMT underwent an ultrasound examination before diagnosis, and the sonographic characteristics were analyzed and compared with the clinical findings. Results The sensitivity and specificity of an ultrasound diagnosis for CMT was 95.83% and 83.33%, respectively. The patients were divided into 2 groups based on the stage of the disease: the early-stage group (age <1 year) and the late-stage group(age ≥1 year). Differences existed between the two groups with respect to sonographic findings and clinical characteristics. The sonographic characteristics of the early-stage group included local thickening of the sternocleidomastoid muscle (SCM), weak or uneven echoes, and blood flow signals around or inside most of the lesions. The sonographic characteristics of the late-stage group included diffusely hyperechoic, or cord-like hyperechoic signals inside the muscle layer without significant blood flow signals. Conclusions Different stage of CMT patients had different sonographic characteristics. High-frequency and color Doppler ultrasonography can serve as adjunct confirmation tool for the diagnosis of CMT. PMID:23102117

  20. Enhanced sensitivity in H photofragment detection by two-color reduced-Doppler ion imaging

    SciTech Connect

    Epshtein, Michael; Portnov, Alexander; Kupfer, Rotem; Rosenwaks, Salman; Bar, Ilana

    2013-11-14

    Two-color reduced-Doppler (TCRD) and one-color velocity map imaging (VMI) were used for probing H atom photofragments resulting from the ∼243.1 nm photodissociation of pyrrole. The velocity components of the H photofragments were probed by employing two counterpropagating beams at close and fixed wavelengths of 243.15 and 243.12 nm in TCRD and a single beam at ∼243.1 nm, scanned across the Doppler profile in VMI. The TCRD imaging enabled probing of the entire velocity distribution in a single pulse, resulting in enhanced ionization efficiency, as well as improved sensitivity and signal-to-noise ratio. These advantages were utilized for studying the pyrrole photodissociation at ∼243.1 and 225 nm, where the latter wavelength provided only a slight increase in the H yield over the self-signal from the probe beams. The TCRD imaging enabled obtaining high quality H{sup +} images, even for the low H photofragment yields formed in the 225 nm photolysis process, and allowed determining the velocity distributions and anisotropy parameters and getting insight into pyrrole photodissociation.

  1. Estimation of volume flow rate by surface integration of velocity vectors from color Doppler images.

    PubMed

    Sun, Y; Ask, P; Janerot-Sjöberg, B; Eidenvall, L; Loyd, D; Wranne, B

    1995-01-01

    A new Doppler echocardiographically based method has been developed to quantify volume flow rate by surface integration of velocity vectors (SIVV). Electrocardiographic-gated color Doppler images acquired in two orthogonal planes were used to estimate volume flow rate through a bowl-shaped surface at a given time and distance from the probe. To provide in vitro validation, the method was tested in a hydraulic model representing a pulsatile flow system with a restrictive orifice. Accurate estimates of stroke volume (+/- 10%) were obtained in a window between 1.2 and 1.6 cm proximal to the orifice, just before the region of prestenotic acceleration. By use of the Bernoulli's equation, the estimated flows were used to generate pressure gradient waveforms across the orifice, which agreed well with the measured flows. To demonstrate in vivo applicability, the SIVV method was applied retrospectively to the determination of stroke volume and subaortic flow from the apical three-chamber and five-chamber views in two patients. Stroke volume estimates along the left ventricular outflow tract showed a characteristic similar to that in the in vitro study and agreed well with those obtained by the Fick oxygen method. The region where accurate measurements can be obtained is affected by instrumental factors including Nyquist velocity limit, wall motion filter cutoff, and color flow sector angle. The SIVV principle should be useful for quantitative assessment of the severity of valvular abnormalities and noninvasive measurement of pulsatile volume flows in general.

  2. Feasibility of angle independent Doppler color imaging for in vivo application: preliminary study on carotid arteries.

    PubMed

    Fei, D Y; Liu, D D; Fu, C T; Makhoul, R G; Fisher, M R

    1997-01-01

    An experimental system has been used to acquire Doppler color images using a linear transducer from an ultrasound scanner to reconstruct angle independent Doppler color (AIDC) images in normal carotid arteries in 21 volunteers. Images were first taken from relatively straight segments in the common carotid artery, and comparisons were made in a small area at the center stream. At peak systole, the correlation coefficient of the velocity amplitudes between AIDC imaging (AIDCI) and duplex scanning was 0.94; the correlation coefficient between the flow angles measured from AIDCI and the angles of the vessel wall was 0.99. Periodic variations of the flow angle over the cardiac cycle were always observed by AIDCI, whereas the changes in the geometric angle of the vessel itself were insignificant. This observation suggests that the AIDCI technique is sensitive to alterations of flow direction. On the other hand, the deviation of the flow angle from a fixed correction angle in duplex scanning may cause a certain degree of error in velocity determination. AIDC images were also obtained at the carotid bifurcation. The results show that the AIDCI technique is able to depict major flow features, such as velocity skewing, flow separation, flow reversal and vortical flow, in a complex flow field.

  3. The study of ovarian artery hemodynamics in patients with infertility by color Doppler energy.

    PubMed

    Xiao, X; Le, G; Zhang, Y; Li, C

    2001-01-01

    Seventy-four cases of infertility were examined to study the hemodynamics of the bilateral ovarian arteries at 21st day during the corpus luteum phase by color Doppler energy(CDE) and color Doppler flow imaging (CDFI). All the patients were verified by laparoscopy, fallopian tube patency examination and ovarian function test. Twenty-two healthy women served as controls. The results showed that the difference of resistance index(RI) and pulsatility index (PI) of bilateral ovarian arteries between the infertility and the normal controls had statistical significance (P < 0.01), and the PI showed negative correlation with the thickness of endometrium (left side: r = 0.724, P < 0.01; right side: r = 0.756, P < 0.01). The results also showed that CDE was more sensitive than CDFI in displaying the ovarian arteries. It could be concluded that the elevated resistance of ovarian artery during the corpus luteum phase was one of the important factors that resulted in infertility.

  4. [Echotomography and color-Doppler in the diagnosis of thyroid carcinoma].

    PubMed

    Messina, G; Viceconti, N; Trinti, B

    1996-01-01

    Ultrasound examination of the thyroid gland is used extensively in the diagnosis of thyroid carcinoma: it is easy and rapid to perform and widely available. Ultrasound enables easy identification of the image of disease foci within the gland, especially when high frequency probes (7.5-10 MHz) are used. Thyroid nodules are subdivided on the basis of their echostructure into hypoechoic solid, isoechoic solid, and hyperechoic solid, mixed, and liquid. In neoplastic pathologies, a hypoechoic echostructure is not pathognomonic of malignancy but must be regarded with suspicion, especially if it is an isolated nodule in a male patient and continues to grow during suppressive therapy. In fact, thyroid neoplasms evidence a hypoechoic echostructure in 60-70% of the cases, while a hyperechoic echostructure is present in only 2-4%. Only 15-25% of neoplasms appear as isoechoic nodules; a mixed echostructure is rarely (5-10% of the cases) seen. Color-Doppler patterns are classified into four types: I) nodules without internal or perinodular vascularization; II) nodules with vascularization confined to extranodular tissue; III) nodules with significant intra- and perinodular vascularization; IV) increased vascularization (or "thyroid inferno"). The vast majority of thyroid carcinoma (90%) presents type III vascularization. We therefore suggest the routine use of ultrasonography and color-Doppler studies in conjunction with fine-needle aspiration cytology for the diagnostic evaluation of thyroid carcinoma.

  5. Noninvasive microstructural and velocity imaging in humans by color Doppler optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Yazdanfar, Siavash

    The objective of this dissertation is to develop the optical instrumentation, electronics, and signal processing for high-resolution blood flow imaging using optical coherence tomography (OCT) in human subjects. In particular, in vivo OCT blood flow imaging, termed color Doppler OCT (CDOCT), is applied for the first time to measurements in human vasculature of the retina and skin. CDOCT is similar to color Doppler ultrasound, whereas depth-resolved flow information is extracted from reflectivity profiles obtained from phase-sensitive, low-coherence interferometry. Although CDOCT has been demonstrated in tissue-mimicking phantoms and in living animal models, the technique has not yet been extended to blood flow imaging in humans. In this project, CDOCT was integrated with a modified slit lamp biomicroscope for imaging of retinal blood flow, and additional technical requirements necessary for retinal flow imaging were met. This system was used to acquire the first high resolution, cross-sectional images of blood flow with OCT in humans. The image acquisition rate was increased to examine retinal hemodynamics in normal subjects. A method was introduced for improving the velocity resolution by approximately two orders of magnitude, down to ˜1 micrometer/sec, by calculating the change in the phase across sequential scans. This technique was used to achieve the highest velocity resolution to date in scattering media, and applied to imaging the human microvasculature down to the capillary level. Finally, a modification of CDOCT based on differential phase contrast was introduced for high resolution imaging in the presence of motion artifact. This technique measures the differential Doppler frequency between two beams of orthogonal polarization states that are laterally displaced on the sample. Using polarization diversity detection, the common-mode noise was removed, enabling the measurement of flow in scattering media down to the theoretical frequency resolution.

  6. Contrast-Enhanced Image of Bellicia Crater

    NASA Image and Video Library

    2013-11-06

    In this contrast-enhanced infrared image of Bellicia Crater on the giant asteroid Vesta, scientists from NASA Dawn mission can see signs of the mineral olivine. Olivine was not expected to be found at Bellicia.

  7. Local intense mosaic pattern at site of flail mitral leaflet: report of a new color Doppler sign.

    PubMed

    Khouzam, Rami N; D'Cruz, Ivan A; Minderman, Daniel; Kaiser, Jacqueline

    2005-10-01

    Color flow Doppler has been useful in diagnosing the presence and severity of mitral regurgitation (MR). We noted a hitherto unreported sign of MR due to flail mitral leaflet: intense local mosaic pattern at the site of the flail leaflet. This sign was seen well in 11 of 14 patients (79%) with the two-dimensional echocardiographic features of flail mitral leaflet, all with moderate or severe MR. In 3 other patients, the sign was absent; two of those had flail mitral leaflet with severe MR. No local mosaic pattern was seen on color Doppler in 20 other patients with MR but no flail mitral leaflet. We speculate that the focal intense mosaic color Doppler morphology may have been caused by intrusion of the flail leaflet into the MR stream, or to a Coanda-like effect of the MR jet "adhering" to the flail leaflet.

  8. Aneurysms of the portal venous system. Gray-scale and color Doppler ultrasonographic findings with CT and MRI correlation.

    PubMed

    Atasoy, K C; Fitoz, S; Akyar, G; Aytaç, S; Erden, I

    1998-01-01

    Two cases of incidentally detected aneurysms involving the portal venous system are described with emphasis on gray-scale and color Doppler ultrasonographic (US) findings. Appearing on US as anechoic masses showing direct luminal continuity with the right portal vein and superior mesenteric vein, the lesions displayed spectral findings characteristic of portal venous system on color Doppler US. Dynamic helical computed tomography (CT) demonstrated simultaneous enhancement with the portal system, while the aneurysms were hypointense owing to flow void on T1-weighted spin-echo magnetic resonance (MR) images.

  9. [Intracranial blood flow velocities evaluated by color Doppler (duplex) in preterm infants].

    PubMed

    de Assis, Marcelo Cardoso; Machado, Helio Rubens

    2004-03-01

    In order to ascertain the blood flow velocities in the intracranial arteries we evaluated 73 preterm neonates during a period ranging from June 1994 to March 1999. These preterm infants were divided in two separate groups, 18 healthy and 55 with intracranial hemorrhage. They were subjected to sequential measurements of blood flow velocities in the intracranial arteries. The gestational age of the whole group varied from 28 to 36 weeks and birth weights between 720 and 2530 g. The diagnosis of the intracerebral hemorrhages in these preterm neonates were done using high resolution gray and color scale transfontanellar ultrasonography brain scans. The ultrasound evaluations were performed in the initial 3rd, 7th and 14th day of life. The 73 preterm infants were evaluated with sequential measurements of blood flow velocity in the intracranial arteries using the Doppler technique through the anterior fontanelle. Doppler evaluation of the cerebral vessels were performed on days 3, 7, 30 and 90 of life. These evaluations were performed in the six intracranial arteries, meaning: right and left anterior and middle cerebral arteries and right and left internal carotid arteries. Doppler recordings were made using Duplex Color-Doppler system, pulse echo probe of 3,5; 5,0 and 7,5 MHz. Measuring the blood flow velocity in the cerebral arteries we obtained a maximum systolic velocity and end diastolic velocity with a rate in meters per second (m/s) for each cardiac cycle. After obtaining these numerical values for these velocities we obtained the resistance index (RI) or Pourcelot index. In a progressive way as the resistance index (RI) values were being obtained in each stage of this study they were also being checked in the cerebral arteries of healthy preterm infants and infants with intracranial hemorrhages. We also analyzed in a comparative method the values of the resistive index between the two groups of preterm infants observing their behaviour. The results obtained when

  10. Endoscopic Color Doppler Ultrasonographic Evaluation of GastricVarices Secondary to Left-Sided Portal Hypertension

    PubMed Central

    Sato, Takahiro; Yamazaki, Katsu; Kimura, Mutsuumi; Toyota, Jouji; Karino, Yoshiyasu

    2014-01-01

    Gastric varices that arise secondary to the splenic vein occlusion can result in gastrointestinal hemorrhaging. Endoscopic color Doppler ultrasonography (ECDUS) was performed in 16 patients with gastric varices secondary to splenic vein occlusion. This study retrospectively evaluated the role of ECDUS in the diagnosis of gastric varices secondary to splenic vein occlusion. Thirteen patients had co-existing pancreatic diseases: 8 with chronic pancreatitis, 4 with cancer of the pancreatic body or tail and 1 with severe acute pancreatitis. Of the remaining 3 patients, 1 had myeloproliferative disease, 1 had advanced gastric cancer, and the third had splenic vein occlusion due to an obscure cause. The endoscopic findings of gastric varices were: variceal form (F) classified as enlarged tortuous (F2) in 12 cases and large, coil-shaped (F3) in 4 cases, and positive for erosion or red color sign of the variceal surface in 4 cases and negative in 12 cases. ECDUS color flow images of gastric variceal flow clearly depicted a round fundal region at the center, with varices expanding to the curvatura ventriculi major of the gastric body in all 16 cases. The velocities of F3 type gastric varices were significantly higher than those of the F2 type. The wall thickness of varices positive for erosion or red color sign was significantly less than the negative cases. I conclude that ECDUS color flow images of gastric variceal flow depicted specific findings of gastric varices secondary to splenic vein occlusion at the round fundal region at the center, with varices expanding to the curvatura ventriculi major of the gastric body. PMID:26852679

  11. Color-Doppler sonography in chronic venous insufficiency: what the radiologist should know.

    PubMed

    Cina, Alessandro; Pedicelli, Alessandro; Di Stasi, Carmine; Porcelli, Alessandra; Fiorentino, Alessandro; Cina, Gregorio; Rulli, Francesco; Bonomo, Lorenzo

    2005-01-01

    Chronic venous insufficiency (CVI) is a pathologic condition caused by valvular incompetence, with or without associated venous outflow obstruction, which may affect both the superficial and the deep venous system, causing venous hypertension and stasis. The most common form of CVI is primary varicose veins due to the insufficiency of the saphenous system. Color-Doppler sonography (CDS) is actually the main diagnostic technique of imaging for CVI. In this article, we describe the anatomy, the technique, and the information necessary to the radiologist to perform CDS in chronic venous insufficiency. The knowledge of the venous anatomy is the cornerstone for an adequate sonographic examination. The venous network in the lower extremities is divided into three systems: superficial, deep, and perforating veins. Deep veins are "comitantes" to the corresponding arteries and run under the muscular fascia. Superficial veins course into the subcutaneous fat, superficially to the deep muscular fascia; the main superficial veins are the greater and lesser saphenous and their tributaries. Connection between the saphenous veins are defined as communicating veins. Superficial and deep veins are connected by perforating veins, with flow directed, under normal circumstances, from the superficial to the deep system. The main perforating are the Hunter in the mid thigh, the Dodd in the lower thigh, the Boyd in the upper calf, and the Cockett's in the middle and lower calf. Sonographic examination must be performed in the upright and supine position. Compression sonography and color and PW Doppler are systematically employed to assess the absence of deep venous thrombosis. Femoro-popliteal veins are evaluated with color and PW Doppler for valvular insufficiency with reflux by performing Valsalva maneuver and calf compression. The sapheno-femoral and sapheno-popliteal junctions are examined to identify type of junction, continence, accessory saphenous, and incompetent collaterals

  12. Assessment of severity of mitral regurgitation by measuring regurgitant jet width at its origin with transesophageal Doppler color flow imaging.

    PubMed

    Tribouilloy, C; Shen, W F; Quéré, J P; Rey, J L; Choquet, D; Dufossé, H; Lesbre, J P

    1992-04-01

    The ability of transesophageal color Doppler echocardiography to provide high-resolution images of both cardiac structure and blood flow in real time is advantageous for many clinical purposes. This study was performed to determine the utility of the regurgitant jet width at its origin measured by transesophageal Doppler color flow imaging in the assessment of severity of mitral regurgitation. Sixty-three consecutive patients with mitral regurgitation underwent transesophageal color Doppler examination, and the diameter of regurgitant jet at its origin was measured. Both right and left cardiac catheterizations were performed within 24 hours of Doppler studies, and angiographic grading of mitral regurgitation and regurgitant stroke volume were evaluated. There was a close relation between the jet diameter at its origin measured by transesophageal Doppler color flow imaging and the angiographic grade of mitral regurgitation (r = 0.86, p less than 0.001). A jet diameter of 5.5 mm or more identified severe mitral regurgitation (grade III or IV) with a sensitivity of 92%, specificity of 92%, and positive and negative predictive values of 88% and 95%, respectively. In 31 patients with isolated mitral regurgitation, the jet diameter correlated well with the regurgitant stroke volume determined by a combined hemodynamic-angiographic method (r = 0.85, p less than 0.001). A jet diameter of 5.5 mm or more identified a regurgitant stroke volume of 60 ml or more with a sensitivity of 88%, specificity of 93%, and positive and negative predictive values of 94% and 87%, respectively. The regurgitant jet width at its origin measured by transesophageal Doppler color flow imaging provides a simple and useful method of measuring the severity of mitral regurgitation, and it may allow differentiation between mild and severe mitral regurgitation.

  13. Assessment of subclinical atherosclerosis using contrast-enhanced ultrasound.

    PubMed

    van den Oord, Stijn C H; ten Kate, Gerrit L; Akkus, Zeynettin; Renaud, Guillaume; Sijbrands, Eric J G; ten Cate, Folkert J; van der Lugt, Aad; Bosch, Johan G; de Jong, Nico; van der Steen, Antonius F W; Schinkel, Arend F L

    2013-01-01

    The sensitivity of standard carotid ultrasound and colour Doppler for the detection of subclinical atherosclerotic plaques is suboptimal. The aim of this study is to assess whether contrast-enhanced ultrasound (CEUS) added to standard carotid ultrasound improves the detection of subclinical atherosclerosis. Carotid intima-media thickness (CIMT) measurement, standard carotid ultrasound including colour Doppler imaging, and CEUS were performed in 100 asymptomatic patients with one or more risk factors for atherosclerosis. CEUS was performed using intravenous administration of SonoVue™ contrast agent (Bracco S.p.A., Milan, Italy). CIMT, standard ultrasound, colour Doppler, and CEUS were reviewed by two independent observers. Standard ultrasound, colour Doppler, and CEUS were scored for the presence of atherosclerotic plaques. Subclinical atherosclerosis was diagnosed if patients had a CIMT above their age-corrected threshold value or if atherosclerotic plaques were present on standard carotid ultrasound clips or CEUS clips. McNemar's test was performed to compare between groups. Twenty-one patients (21%) had a thickened CIMT value and were considered to have subclinical atherosclerosis. Standard carotid ultrasound including colour Doppler demonstrated atherosclerotic plaques in 77 patients (77%). The addition of CEUS to the standard ultrasound protocol demonstrated atherosclerotic plaques in 88 patients (88%). The incorporation of CEUS into the standard carotid ultrasound protocol resulted in a significantly improved detection of patients with subclinical atherosclerosis (P < 0.01). CEUS has an incremental value for the detection of subclinical atherosclerosis in the carotid arteries. Atherosclerotic plaques which were only detected with CEUS and not with standard carotid ultrasound and colour Doppler imaging were predominantly hypoechoic.

  14. Accuracy of color Doppler ultrasonography and magnetic resonance imaging in diagnosis of placenta accreta: A survey of 82 cases

    PubMed Central

    Ayati, Sedigheh; Leila, Leila; Pezeshkirad, Masoud; Seilanian Toosi, Farokh; Nekooei, Sirous; Shakeri, Mohammad Taghi; Golmohammadi, Mansoureh Sadat

    2017-01-01

    Background: Placenta adhesive disorder (PAD) is one of the most common causes of postpartum hemorrhage and peripartum hysterectomy. The main risk factors are placenta previa and prior uterine surgery such as cesarean section. Diagnosis of placenta adhesive disorders can lead to a decrease of maternal mortality and morbidities. Objective: The purpose of this study was to compare the accuracy of color Doppler ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of PADs. Materials and Methods: In this is cross-sectional study, Eighty-two pregnant women who were high risk for PAD underwent color Doppler ultrasound and MRI after 18 weeks of gestation. The sonographic and MRI findings were compared with the final pathologic or clinical findings. P<0.05 was considered statistically significant. Results: Mean maternal age was 31.42±4.2 years. The average gravidity was third pregnancy. 46% of patients had placenta previa. The history of the previous cesarean section was seen in 79 cases (96%). The diagnosis of placenta adhesive disorder was found in 17 cases (21%). Doppler sonography sensitivity was 87% and MRI sensitivity was 76% (p=0.37). Doppler sonography specificity was 63% and MRI specificity was 83% (p=0.01). Conclusion: Women with high-risk factors for PAD should undergo Doppler ultrasonography at first. When results on Doppler sonography are equivocal for PAD, MRI can be performed due to its high specificity. PMID:28835939

  15. Pulsed color-flow Doppler analysis of arterial deficiency in idiopathic clubfoot.

    PubMed

    Katz, Danielle A; Albanese, Eileen L; Levinsohn, E Mark; Hootnick, David R; Packard, David S; Grant, William D; Mann, Kenneth A; Albanese, Stephen A

    2003-01-01

    This prospective study used pulsed color-flow Doppler sonography to determine differences in the presence and direction of flow through the dorsalis pedis, posterior tibial, and peroneal arteries in a group of children with clubfoot and a comparison group of controls. There was a statistically significant difference in the prevalence of deficient (absent or retrograde flow) dorsalis pedis arteries in children with clubfoot (45%) compared with controls (8%). This indicates that there is an association between some clubfeet and deficiency of the dorsalis pedis artery. There was a trend toward difference in the prevalence of deficiency of the dorsalis pedis artery in the clubfeet that required surgery (54%) compared with those that did not (20%), suggesting that dorsalis pedis artery deficiency may be more prevalent among clubfeet with greater deformity.

  16. Color Doppler Ultrasound Study of Glomuvenous Malformations with its Clinical and Histologic Correlations.

    PubMed

    Wortsman, X; Millard, F; Aranibar, L

    2017-07-03

    Glomuvenous malformations are hamartomatous lesions characterized by the presence of glomus cells in the vascular smooth muscle. We present the clinical and color Doppler ultrasound features of a series of 13 cases of histologically confirmed glomuvenous malformations. In all cases, the ultrasound study revealed moderately delimited superficial dermal and hypodermal pseudonodular structures of mixed echogenicity, with hypoechoic and heterogeneous areas and anechoic, pseudocystic tubular and lacunar zones. Arterial and venous vessels, mainly with a low flow (≤ 15cm/s) were observed in 85% of patients, but no arteriovenous shunts were present. Deeper structures were not affected and no phleboliths were detected. The clinical and ultrasound findings could facilitate diagnosis, surgical planning, and noninvasive follow-up in these tumors. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. [Ultrasound and color Doppler applications in nephrology. The normal kidney: anatomy, vessels and congenital anomalies].

    PubMed

    Meola, Mario; Petrucci, Ilaria; Giovannini, Lisa; Samoni, Sara; Dellafiore, Carolina

    2012-01-01

    Gray-scale ultrasound is the diagnostic technique of choice in patients with suspected or known renal disease. Knowledge of the normal and abnormal sonographic morphology of the kidney and urinary tract is essential for a successful diagnosis. Conventional sonography must always be complemented by Doppler sampling of the principal arterial and venous vessels. B-mode scanning is performed with the patient in supine, prone or side position. The kidney can be imaged by the anterior, lateral or posterior approach using coronal, transverse and oblique scanning planes. Morphological parameters that must be evaluated are the coronal diameter, the parenchymal thickness and echogenicity, the structure and state of the urinary tract, and the presence of congenital anomalies that may mimic a pseudomass. The main renal artery and the hilar-intraparenchymal branches of the arterial and venous vessels should be accurately evaluated using color Doppler. Measurement of intraparenchymal resistance indices (IP, IR) provides an indirect and quantitative parameter of the stiffness and eutrophic or dystrophic remodeling of the intrarenal microvasculature. These parameters differ depending on age, diabetic and hypertensive disease, chronic renal glomerular disease, and interstitial, vascular and obstructive nephropathy.

  18. Transcranial color Doppler in stroke-free adult patients with sickle cell disease.

    PubMed

    Graziadei, G; Casoni, F M; Annoni, F; Cortinovis, I; Ridolfi, P; Gandolfi, I; Marcon, A; Di Pierro, E; Cappellini, M D

    2017-09-01

    The threshold velocity ≥200 cm/s at transcranial Doppler (TCD) evaluation is a useful cut-off for preventing the stroke (STOP trial) in pediatric patients with sickle cell disease (SCD), term including different types of sickle genotypes. Scanty data are available for adult SCD patients. We compared intracranial blood flow velocities between adult SCD patients and controls using transcranial color Doppler (TCCD), measuring the peak of systolic velocity (PSV) with the insonation angle correction and the pulsatility index (PI), an indicator of endothelial elasticity. Fifty-three adult SCD patients (aged >18 years) were enrolled (15 sickle cell anemia, 26 sickle cell thalassemia, and 12 HbS/HbC). None of the patients presented neurological signs. PSVs in middle cerebral artery (MCA) were higher in SCD patients than in controls (p = 0.001). In sickle cell anemia patients, PSVs were higher when compared to HbS/βThal (p < 0.0060) and HbS/HbC patients (p < 0.0139). PI was within the lower range of normality in SCD patients compared to controls. Moreover, MCA-PSV was higher with lower Hb levels and higher HbS%; PI did not change with variation of Hb levels and HbS%.PSV and PI in SCD adult patients could be a relevant index to indicate the abnormal cerebral blood flow and to detect the sickle endothelial damage, in order to prevent cerebrovascular accidents.

  19. Carotid turbulent flow observed by convergent color Doppler flowmetry in silent cerebral infarction.

    PubMed

    Ohyama, Mie; Mizushige, Katsufumi; Ohyama, Hideo; Takahashi, Tsutomu; Hosomi, Naohisa; Ichihara, Shin-Ichiro; Kohno, Masakazu

    2002-04-01

    A newly developed convergent color Doppler (CCD) was used for evaluating the possible relationship of the flow dynamics of the internal carotid artery to silent cerebral infarction (SCI). In 108 patients (65+/-8 years) with stroke risk factors, the CCD simultaneously images information, on both flow direction and Doppler signal energy. The relation between turbulent flow and the incidence of brain lesions of SCI as identified by magnetic resonance imaging was investigated in 212 vessels, excluding four occluded vessels. Percent area stenosis was measured as (vessel area - lumen area)/(vessel area) on cross-sectional echo image of stenotic site. Incidence of turbulent flow in SCI patients with 50-70% or 70-90% stenosis was higher (76.5 or 59.1%) than that in non-SCI patients (17.4 or 33.3%, both p < 0.0001). Non-invasive assessment of flow dynamics by CCD imaging can be useful for proposing the early stages of brain damage even in patients free from neurological deficits.

  20. [Ultrasonic quantification, value of color and contribution of transcranial Doppler sonography in carotid artery surgery].

    PubMed

    Berni, A; Cavaiola, S; Mele, R; Tombesi, T; Custureri, F; D'Andrea, V; Marchesi, M; Tromba, L

    1996-05-01

    The authors briefly report their experience regarding the opportunities offered by the use of current ultrasound methods in carotid surgery. They describe: a system for the quantification of athcromasic plaque used to monitor non-operated patients over time; ultrasound methods used to analyse the carotid wall to establish whether it can be utilised as an index of vascular aggression in hypertension, diabetes and atherosclerosis; the use of transcranial Doppler; criteria for the definition of high risk plaque; the applications of eco-color Doppler. The paper also illustrates a new pathology identified by the authors, defined as primary intimal fibrous hyperplasia, and the evolution of the carotid wall after endarterectomy. The structural characteristics of primary hyperplasia can only be shown using ultrasound given that arteriography cannot distinguish it from atheromatic stenosis. After endarterectomy the carotid wall is subject to hematic and hemodynamic stimuli which determine the type of evolution of the wall itself. The authors therefore examine the myointimal reaction, myointimal hyperplasia, early restenosis and late restenosis as different facets of the same phenomenon.

  1. Primary thyroid lymphoma has different sonographic and color Doppler features compared to nodular goiter.

    PubMed

    Wang, Zhongqing; Fu, Bin; Xiao, Ying; Liao, Jintang; Xie, Ping

    2015-02-01

    The purpose of this study was to determine the specific sonographic features of primary thyroid lymphoma and its color Doppler pattern compared to nodular goiter. The sonographic findings for 13 surgically proven primary thyroid lymphomas were analyzed and compared to those for 27 nodular goiters. In accordance with the suggested pathologic patterns, the sonographic patterns of primary thyroid lymphoma could be classified into diffuse and nodular or segmental types based on the distribution of hypoechoic and echogenic structures within the lesions. Some common sonographic characteristics suggesting thyroid malignancy could not facilitate differentiation of primary thyroid lymphoma from nodular goiter. However, a central blood flow pattern would favor the diagnosis of primary thyroid lymphoma, whereas a peripheral pattern would suggest the diagnosis of nodular goiter. Primary thyroid lymphoma has characteristic sonographic and Doppler flow features. Along with several other parameters, a central blood flow pattern would highly suggest the diagnosis of primary thyroid lymphoma rather than nodular goiter. © 2015 by the American Institute of Ultrasound in Medicine.

  2. "Focal thyroid inferno" on color Doppler ultrasonography: a specific feature of focal Hashimoto's thyroiditis.

    PubMed

    Fu, Xianshui; Guo, Limei; Zhang, Huabin; Ran, Weiqiang; Fu, Peng; Li, Zhiqiang; Chen, Wen; Jiang, Ling; Wang, Jinrui; Jia, Jianwen

    2012-11-01

    To evaluate color-Doppler features predictive of focal Hashimoto's thyroiditis. A total of 521 patients with 561 thyroid nodules that underwent surgeries or gun biopsies were included in this study. These nodules were divided into three groups: focal Hashimoto's thyroiditis (104 nodules in 101 patients), benignity other than focal Hashimoto's thyroiditis (73 nodules in 70 patients), and malignancy (358 nodules in 350 patients). On color Doppler sonography, four vascularity types were determined as: hypovascularity, marked internal flow, marked peripheral flow and focal thyroid inferno. The χ2 test was performed to seek the potential vascularity type with the predictive ability of certain thyroid pathology. Furthermore, the gray-scale features of each nodule were also studied. The vascularity type I (hypovascularity) was more often seen in focal Hashimoto's thyroiditis than other benignity and malignancy (46% vs. 20.5% and 19%). While the type II (marked internal flow) showed the opposite tendency (26.9% [focal Hashimoto's thyroiditis] vs. 45.2% [other benignity] and 52.8% [malignancy]). However, type III (marked peripheral flow) was unable to predict any thyroid pathology. Importantly, type IV (focal thyroid inferno) was exclusive to focal Hashimoto's thyroiditis. All 8 type IV nodules appeared to be solid, hypoechoic, and well-defined. Using "focal thyroid inferno" as an indicator of FHT, the diagnostic sensitivity and specificity were 7.7% and 100% respectively. The vascularity type of "focal thyroid inferno" is specific for focal Hashimoto thyroiditis. Recognition of this particular feature may avoid unnecessary interventional procedures for some solid hypoechoic thyroid nodules suspicious of malignancy. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. [Diagnosis of placenta previa accreta by two dimensional ultrasonography and color doppler in patients with cesarean section].

    PubMed

    Shi, Huafang; Pi, Pixiang; Ding, Yiling

    2012-09-01

    To determine the accuracy of two dismensional sonography and color doppler in diagnosing placenta previa accreta in patients with previous cesarean section. Forty-one patients with previous cesarean sections were confirmed to have partial or total placenta previa in the current pregnancy and were given ultrasound examinations after the 28th week of gestation. Specific ultrasound features of the placenta and its interphase with the uterus and the bladder for placenta accreta were checked by two-dimensional ultrasonography and color Doppler. All the patients were traced until delivery. The golden standard in diagnosis was the intraoperative finding and the pathologic exam. Twenty-two patients had ultrasonographic evidence of placenta previa, 20 of which were later confirmed placenta previa accreta intraoperatively. Nineteen patients had no ultrasound evidence of placenta previa, and 1 of which was later confirmed placenta previa accreta. The sensitivity and specificity of antenatal ultrasound diagnosis of placenta previa accreta were 95.24% and 94.74% respectively. The most prominent feature to suggest placenta accreta in twodismensional sonography was the presence of multiple lakes that represented dilated vessels extending from the placenta through the myometrium. The most prominent color Doppler feature was the presence of interphase hypervascularity with abnormal vessels linking the placenta to the bladder, and the rate was 95.24%. Placenta previa accreta can be diagnosed made with a thorough two dimensional ultrasonographic and color Doppler examination in patients with previous cesarean scar and placenta previa.

  4. Dual-energy contrast-enhanced mammography.

    PubMed

    Travieso Aja, M M; Rodríguez Rodríguez, M; Alayón Hernández, S; Vega Benítez, V; Luzardo, O P

    2014-01-01

    The degree of vascularization in breast lesions is related to their malignancy. For this reason, functional diagnostic imaging techniques have become important in recent years. Dual-energy contrast-enhanced mammography is a new, apparently promising technique in breast cancer that provides information about the degree of vascularization of the lesion in addition to the morphological information provided by conventional mammography. This article describes the state of the art for dual-energy contrast-enhanced mammography. Based on 15 months' clinical experience, we illustrate this review with clinical cases that allow us to discuss the advantages and limitations of this technique.

  5. Clinical evaluation of contrast-enhanced digital mammography and contrast enhanced tomosynthesis--Comparison to contrast-enhanced breast MRI.

    PubMed

    Chou, Chen-Pin; Lewin, John M; Chiang, Chia-Ling; Hung, Bao-Hui; Yang, Tsung-Lung; Huang, Jer-Shyung; Liao, Jia-Bin; Pan, Huay-Ben

    2015-12-01

    To compare the diagnostic accuracy of contrast-enhanced digital mammography (CEDM) and contrast-enhanced tomosynthesis (CET) to dynamic contrast enhanced breast MRI (DCE-MRI) using a multireader-multicase study. Institutional review board approval and informed consents were obtained. Total 185 patients (mean age 51.3) with BI-RADS 4 or 5 lesions were evaluated before biopsy with mammography, tomosynthesis, CEDM, CET and DCE-MRI. Mediolateral-oblique and cranio-caudal views of the target breast CEDM and CET were acquired at 2 and 4 min after contrast agent injection. A mediolateral-oblique view of the non-target breast was taken at 6 min. Each lesion was scored with forced BI-RADS categories by three readers. Each reader interpreted lesions in the following order: mammography, tomosynthesis, CEDM, CET, and DCE-MRI during a single reading session. Histology showed 81 cancers and 144 benign lesions in the study. Of the 81 malignant lesions, 44% (36/81) were invasive and 56% (45/81) were non-invasive. Areas under the ROC curve, averaged for the 3 readers, were as follows: 0.897 for DCE-MRI, 0.892 for CET, 0.878 for CEDM, 0.784 for tomosynthesis and 0.740 for mammography. Significant differences in AUC were found between the group of contrast enhanced modalities (CEDM, CET, DCE-MRI) and the unenhanced modalities (all p<0.05). No significant differences were found in AUC between DCE-MRI, CET and CEDM (all p>0.05). CET and CEDM may be considered as an alternative modality to MRI for following up women with abnormal mammography. All three contrast modalities were superior in accuracy to conventional digital mammography with or without tomosynthesis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Variable color Doppler sonographic appearances of retained products of conception: radiologic-pathologic correlation.

    PubMed

    Kamaya, Aya; Krishnarao, Priya M; Folkins, Ann K; Jeffrey, R Brooke; Desser, Terry S; Maturen, Katherine E

    2015-10-01

    Retained products of conception (RPOC) displays variable vascularity, ranging from avascular to markedly vascular on color Doppler sonography. We hypothesize that variability in sonographic vascularity may be due to histopathologic variation in the placental tissue. After institutional review board approval, sonographic images and pathologic specimens were retrospectively reviewed in 26 patients with pathologically proven RPOC. Ultrasound (US) images were scored 0-3 for the degree of vascularity by two radiologists blinded to the diagnosis. Corresponding pathologic specimens were evaluated for vascularization of chorionic villi, degree of inflammation, morphology of maternal arteries, chorionic villous preservation, and percentage of clot, membranes, chorionic villi, and decidua/myometrium. Statistical analysis, including multiple linear regression, was performed. RPOC with histologically avascular chorionic villi or those with markedly reduced vascularization had significantly lower US vascularity scores (p = 0.030) than those with chorionic villi showing normal or decreased vascularization. Sonographically avascular RPOC had a significantly lower percentage villi (p = 0.028) and higher percentage of decidua (p = 0.004) than specimens where US showed any Doppler vascularity. Histologic vascularity of villi (p = 0.049) and non-observation of maternal arteries (p = 0.001) were significant predictors of US vascularity scores in multivariate linear regression analysis, while inflammation of villi (p = 0.053) was a marginally significant predictor. Histologic vascularity of villi appears to contribute to the observed variation in sonographic vascularity. This finding may underlie known differences in clinical outcomes between sonographic vascularity groups.

  7. Betamethasone treatment and fetal lung perfusion evaluated with color Doppler energy imaging.

    PubMed

    Dubiel, M; Gudmundsson, S; Pirhonen, J; Breborowicz, G H; Marsal, K

    1997-10-01

    The aim of this study was semiquantitative evaluation of tissue blood flow in the fetal lung before and after administration of betamethasone. This was carried out by means of computer analysis of ultrasound Doppler signals obtained by the color Doppler energy (CDE) technique. CDE signals were recorded in 20 singleton pregnancies with appropriate growth and imminent preterm delivery between 26 and 33 weeks of gestation. The CDE signal recordings were made before and after intramuscular administration of betamethasone 8 mg/day for 3 days. Fixed preset CDE system control settings for the fetal right lung were used during the examinations. Images from CDE scans were recorded on S-VHS videotape and transmitted for computer analysis of 8-bit images at 256 gray-scale levels. The mean flow signal intensity was recorded for the fetal lung before and after betamethasone administration. Additionally, blood velocity waveforms were measured in the intrapulmonary arteries and veins in the peripheral part of the lung. CDE signals from the fetal lung indicated increased energy values after corticosteroid treatment in 16 cases. In three cases there was no change in CDE signal values, and in one case a fall of the signal value was noted. Blood velocity waveforms from the intrapulmonary arteries showed decreased resistance to flow in 15 cases, increased resistance to flow in four cases and no change in one case. No significant differences in venous blood flow velocities were found. In conclusion, the results suggest that there is an increase in fetal lung blood perfusion after maternal corticosteroid administration.

  8. Ultrasonographic Characteristics of the Common Extensor Tendon of the Elbow in Asymptomatic Individuals: Thickness, Color Doppler Activity, and Bony Spurs

    PubMed Central

    Krogh, Thøger P.; Fredberg, Ulrich; Ammitzbøl, Christian; Ellingsen, Torkell

    2017-01-01

    Background: Ultrasonography (US) of the common extensor tendon (CET) of the elbow is often part of the assessment of patients with lateral epicondylitis. This US assessment is currently based on general tendinopathy references and not well-defined US entities. Purpose: To describe CET thickness, color Doppler activity, and bony spurs on US in asymptomatic volunteers and to investigate the influence of sex, age, height, body mass index (BMI), weight, and elbow dominance on the measurements. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Tendon thickness, color Doppler activity, and bony spurs of the CET were measured sonographically in 264 adults (50% women) aged 20 to 96 years. Two different tendon-thickness measuring techniques were applied, labeled the “plateau measure” and the “1-cm measure.” Color Doppler activity was based on a 0 to 4 rating scale (negative, grades 0 and 1; positive, grades 2-4). A bony spur was defined as a bony outgrowth (≥0.3 mm) arising at the insertional site of the CET. Results: With both tendon-thickness measuring techniques, the CET in the dominant elbow was thicker than that in the nondominant elbow, and male tendons were thicker than female tendons (all P ≤ .03). In regression analysis, tendon thickness correlated with weight, color Doppler activity, and arm dominance for both measuring techniques in multiple regression analysis. In addition, the plateau measure correlated with height and the presence of bony spurs. No correlations were observed regarding BMI, sex, or age. Positive color Doppler activity was found in 9% of examined elbows, with no difference between the sexes regarding dominant versus nondominant elbows (all P ≥.20). Bony spurs were found to increase with age, from 23% for people in their 20s to 74% in people older than 70 years. Bony spurs were more common in the dominant elbow (P ≤ .01). Women had a higher prevalence of bony spurs than men, but only in the dominant elbow (P

  9. Adaptive overlapped sub-blocks contrast enhancement

    NASA Astrophysics Data System (ADS)

    Chen, Anqiu; Yuan, Fei; Liu, Jing; Liu, Siqi; Li, An; Zheng, Zhenrong

    2016-09-01

    In this paper, an overlapped sub-block gray-level average method for contrast enhancement is presented. The digital image correction of uneven illumination under microscope transmittance is a problem in image processing, also sometimes the image in the dark place need to correct the uneven problem. A new correction method was proposed based on the mask method and sub-blocks gray-level average method because Traditional mask method and background fitting method are restricted due to application scenarios, and the corrected image brightness is low by using background fitting method, so it has some limitations of the application. In this paper, we introduce a new method called AOSCE for image contrast enhancement. The image is divided into many sub-blocks which are overlapped, calculate the average gray-level of the whole image as M and the calculate the average gray-level of each one as mi, next for each block it can get d = mi - m, each block minus d to get a new image, and then get the minimum gray-level of each block into a matrix DD to get the background, and use bilinearity to get the same scale of the image. over fitting the image in matlab in order to get smoother image, then minus the background to get the contrast enhancement image.

  10. Stimulated acoustic emission detected by transcranial color doppler ultrasound : a contrast-specific phenomenon useful for the detection of cerebral tissue perfusion.

    PubMed

    Pohl, C; Tiemann, K; Schlosser, T; Becher, H

    2000-07-01

    Experimental and clinical data suggest that insonation of echo-contrast agents with high acoustical power produces disintegration of microbubbles, resulting in a pseudo-Doppler phenomenon called stimulated acoustic emission (SAE). The purpose of this study was to investigate whether SAE might be detected by transcranial color Doppler imaging and whether these signals might be used for cerebral tissue perfusion measurements. Nonmoving microbubbles (SHU 563 A) were insonated in vitro through the temporal parts of a human cadaver skull, and contrast signals were detected by velocity-coded color Doppler and power Doppler recordings. Transcranial color as well as power Doppler investigations were performed in 10 healthy volunteers with the echo-contrast agent Levovist (SHU 508 A). Color Doppler signals indicating SAE were observed in vitro and in transcranial human investigations. These signals were characterized by a mosaic of color Doppler pixels ranging over the full color scale. Apparent velocity information and spatial distribution of SAE signals changed from image frame to image frame. In the experimental model, the intensity of SAE signals decreased exponentially over time. With an increase of acoustic power, there was a significant increase of the maximum signal intensity (P<0.01) and a significantly shortened signal duration (P<0.01), consistent with stronger and more rapid disintegration. In humans, SAE signals were clearly detected in cerebral tissue regions. The intensity of SAE signals in those regions (eg, temporal cortex, 3.7+/-1.2 dB) was approximately 8 times lower than the signal enhancement in the major cerebral arteries (eg, in the MCA, 29.5+/-5.6). Echo-contrast specific color Doppler signals known as SAE are detectable by transcranial color and power Doppler sonography. Signals due to SAE might represent tissue perfusion, thereby providing a method for imaging flow with transcranial ultrasound.

  11. Contrast-enhanced ultrasound in differentiating malignant from benign portal vein thrombosis in hepatocellular carcinoma

    PubMed Central

    Tarantino, Luciano; Ambrosino, Pasquale; Di Minno, Matteo Nicola Dario

    2015-01-01

    Portal vein thrombosis (PVT) may occur in liver cirrhosis patients. Malignant PVT is a common complication in cirrhotic patients with concomitant hepatocellular carcinoma (HCC) and, in some cases, it may be even the initial sign of an undetected HCC. Detection of malignant PVT in a patient with liver cirrhosis heavily affects the therapeutic strategy. Gray-scale ultrasound (US) is widely unreliable for differentiating benign and malignant thrombi. Although effective for this differential diagnosis, fine-needle biopsy remains an invasive technique. Sensitivity of color-doppler US in detection of malignant thrombi is highly dependent on the size of the thrombus. Contrast-enhanced computed tomography (CT) and contrast-enhanced magnetic resonance (MRI) can be useful to assess the nature of portal thrombus, while limited data are currently available about the role of positron emission tomography (PET) and PET-CT. In contrast with CT, MRI, PET, and PET-CT, contrast-enhanced ultrasound (CEUS) is a fast, effective, well tolerated and cheap technique, that can be performed even in the same session in which the thrombus has been detected. CEUS can be performed bedside and can be available also in transplanted patients. Moreover, CT and MRI only yield a snapshot analysis during contrast diffusion, while CEUS allows for a continuous real-time imaging of the microcirculation that lasts several minutes, so that the whole arterial phase and the late parenchymal phase of the contrast diffusion can be analyzed continuously by real-time US scanning. Continuous real-time monitoring of contrast diffusion entails an easy detection of thrombus maximum enhancement. Moreover, continuous quantitative analyses of enhancement (wash in - wash out studies) by CEUS during contrast diffusion is nowadays available in most CEUS machines, thus giving a more sophisticated and accurate evaluation of the contrast distribution and an increased confidence in diagnosis in difficult cases. In conclusion

  12. Evaluation of color Doppler in guiding prostate biopsy after HIFU ablation.

    PubMed

    Rouvière, Olivier; Mège-Lechevallier, Florence; Chapelon, Jean-Yves; Gelet, Albert; Bouvier, Raymonde; Boutitie, Florent; Lyonnet, Denis

    2006-09-01

    Transrectal ultrasound cannot accurately depict early cancer recurrences after prostate high-intensity focused ultrasound (HIFU) ablation. We evaluated transrectal color Doppler (CD) in guiding post-HIFU prostate biopsy. Prostate CD-guided sextant biopsies were obtained in 82 patients who had undergone prostate HIFU ablation for cancer, 24 of whom had hormone therapy before the treatment. At the time of biopsy, a subjective CD score was given to all biopsy sites (0=no flow; 1=minimal flow; 2=suspicious flow pattern). CD findings were compared with biopsy results. CD was a significant predictor of biopsy findings, according to univariate and multivariate site-by-site analysis. However, only 36 of 94 sites with residual cancer had positive CD findings, and thus, negative CD findings should not preclude random biopsy. There was a significant interaction between CD diagnostic capability and a history of hormone therapy before HIFU treatment. CD was a significant and independent predictor of biopsy findings in patients who had not received hormone therapy (odds ratio: 4.4; 95%CI: 2.5-7.9; p<0.0001), but not in those who had (odds ratio: 1.3; 95%CI: 0.5-3.4; p>0.5). Biopsy taken in CD-positive sites were 4.4 times more likely to contain cancer in patients who did not receive hormone therapy. CD could not reliably depict cancer recurrence in patients with history of hormone therapy.

  13. Characterization of intraventricular flow patterns in healthy neonates from conventional color-Doppler ultrasound

    NASA Astrophysics Data System (ADS)

    Tejman-Yarden, Shai; Rzasa, Callie; Benito, Yolanda; Alhama, Marta; Leone, Tina; Yotti, Raquel; Bermejo, Javier; Printz, Beth; Del Alamo, Juan C.

    2012-11-01

    Left ventricular vortices have been difficult to visualize in the clinical setting due to the lack of quantitative non-invasive modalities, and this limitation is especially important in pediatrics. We have developed and validated a new technique to reconstruct two-dimensional time-resolved velocity fields in the LV from conventional transthoracic color-Doppler images. This non-invasive modality was used to image LV flow in 10 healthy full-term neonates, ages 24-48 hours. Our results show that, in neonates, a diastolic vortex developed during LV filling, was maintained during isovolumic contraction, and decayed during the ejection period. The vortex was created near the base of the ventricle, moved toward the apex, and then back toward the base and LVOT during ejection. In conclusion, we have characterized for the first time the properties of the LV filling vortex in normal neonates, demonstrating that this vortex channels blood from the inflow to the outflow tract of the LV. Together with existing data from adults, our results confirm that the LV vortex is conserved through adulthood. Funded by NIH Grant R21HL108268.

  14. Color-coded Doppler imaging of systolic flow patterns in hypertrophic cardiomyopathy.

    PubMed

    Tencate, F J; Mayala, A P; Vletter, W B; Roelandt, J

    1985-01-01

    We studied 11 patients with hypertrophic cardiomyopathy by color Doppler echocardiography (Group I: 6 patients with outflow obstruction, and Group II: 5 patients without outflow obstruction) to assess systolic structure and function as observed by cross-sectional echocardiography in relation to the flow dynamics. The structure and function included systolic anterior motion of mitral valve (SAM), midsystolic aortic valve closure (AoC), systolic cavity obliteration and the presence and timing of mitral incompetence. Their occurrence and timing was related to presence of aortic systolic flow and presence of turbulence. While all patients in Group I had SAM and turbulence, none of the patients in Group II had SAM nor turbulence. Early mitral incompetence appearing before SAM and turbulence, occurred in all patients of Group I and in none of Group II. Midsystolic aortic valve closure was only present in Group I and blood flow was unilaterally directed so that only 60% of aortic cross-sectional area showed blood flow. We conclude that mitral incompetence in hypertrophic cardiomyopathy in early systole is common when outflow gradient is present and is independent of mitral incompetence of mid- and late systole. During SAM, turbulence in the subaortic area and mid and late mitral incompetence occurred simultaneously. The midsystolic aortic valve closure was related to the unilaterally directed blood flow through the aortic cross-sectional area.

  15. Clinical value of color doppler ultrasound in prenatal diagnosis of umbilical cord entry abnormity

    PubMed Central

    Sun, Jiandong; Wang, Li; Li, Yinghui

    2016-01-01

    Objective: To study the clinical value of prenatal diagnosis of umbilical cord entry abnormity (UCEA) by means of color Doppler ultrasound (CDUS). Methods: Clinical data of sixty-four cases with confirmed umbilical cord entry abnormity were reviewed and the specific UCEA conditions and the outcomes of perinatal infants were analyzed. Results: Detection rates of marginal umbilical cord entry abnormity and velamentous umbilical cord entry abnormity by means of CDUS at second trimester were 94.1% and 93.8% respecdtively much higher than 80.0% and 68.8% which were those of third trimester. Discrepancy had statistical significance (P<0.05). True positive rate of prenatal diagnosis of UCEA by means of CDUS was 85.9% (55/64), and false negative rate was 14.1% (9/64). Among sixty four patients with UCEA, seventeen patients (26.6%) underwent selective caesarean delivery; twenty-six patients (35.9%) underwent emergency caesarean delivery and twenty-four patients (37.5%) had normal delivery. Conclusion: Prenatal diagnosis of UCEA by means of CDUS is intuitive and accurate. It provides an evidence for determination of the best time to diagnose UCEA, and also offers a proper advice for pregnant women about delivery mode to ensure the fetus survival rate, which is clinically valuable. PMID:28083036

  16. Comparison of pulsed wave and color Doppler myocardial velocity imaging in healthy dogs.

    PubMed

    Wess, G; Killich, M; Hartmann, K

    2010-01-01

    Tissue velocity imaging (TVI) is increasingly used in small animal cardiology. Tissue velocity of the myocardial wall can be measured by pulsed wave (PW) or color Doppler (CD) imaging methods. Currently, the same reference ranges are used for PW TVI and CD TVI methods. However, if and how both methods correlate, and whether they can be used interchangeably, have not been assessed in small animals. To compare the results of PW TVI and CD TVI measurements. Seventy-one healthy dogs. Longitudinal myocardial velocity profiles were recorded from the 4-chamber left apical view. Peak maximal systolic (S), early (E), and late diastolic (A) velocities were measured off-line in a blinded fashion in the septal and lateral left ventricular wall by PW TVI and CD TVI. Differences between peak PW TVI and CD TVI waves were analyzed by a paired t-test. Regression analysis and Bland-Altman difference plots also were used to assess agreement between methods. There was a significant correlation between PW TVI and CD TVI (P < .001). However, S, E, and A waves measured by PW TVI were significantly higher than the CD TVI values (P < .001). Peak systolic and diastolic PW velocities were approximately 2.20 cm/s higher than corresponding mean CD TVI velocities. PW TVI measurements are significantly higher compared with CD TVI measurements. Theses differences are clinically relevant. These methods should not be used interchangeably, and different reference ranges for PW TVI and CD TVI should be used.

  17. Assessment of parathyroid glands in hemodialysis patients by using color Doppler sonography.

    PubMed

    Ozcan, Umit Aksoy; Oktay, Ilay

    2009-11-01

    The aim of this study was to assess the role of color and spectral Doppler ultrasound (CDU) in the evaluation of enlarged parathyroid glands in hemodialysis patients with secondary hyperparathyroidism. Fourteen hemodialysis patients with elevated intact parathyroid hormone (iPTH) levels were evaluated prospectively with CDU. The volume of each observed parathyroid gland and the spectral CDU data (velocities, resistance and pulsatility indices, systolic to diastolic ratio, and flow volume output (FVO)) were noted. The biochemical data (iPTH, calcium, phosphate levels), and CDU results were analyzed with the Spearman correlation test. Two patients were excluded, and 27 enlarged parathyroid glands were observed in 12 patients. The mean total volume of enlarged parathyroid glands per patient was 1.95 cm(3) (0.06-5.5 cm(3)). Arterial supply was demonstrated in 78% (21/27) of enlarged parathyroid glands. Mean total FVO of enlarged glands per patient was 238.5 ml/min (620-0 ml/min) and mean iPTH level was 1,477 pg/ml (643-3,132 pg/ml). The positive correlations of total volume (p = 0.022), iPTH (p = 0.024), and FVO (p = 0.022) were statistically significant. In secondary hyperparathyroidism, total volume of the visualized enlarged parathyroid glands and the total of FVOs per patient are positively correlated with iPTH levels which may help clinical management and follow-up of end-stage renal disease patients.

  18. Color Doppler energy and related quantitative analysis of gestational trophoblastic tumors.

    PubMed

    Xie, H; Hata, K; Lu, M; Kong, Q; Miyazaki, K

    1999-06-01

    To assess the reliability of color Doppler energy (CDE) and a related quantitative analysis for detection and follow-up of uterine involvement in gestational trophoblastic tumor. CDE was performed in 19 patients with trophoblastic tumor, in 25 women in early pregnancy and 25 non-pregnant women. The blood flow area ratio (BFAR) in CDE was used as an index representing uterine involvement. In nine of the 19 patients, BFAR was measured before, during and at termination of chemotherapy. The BFAR (mean +/- S.D.) of uterine profiles in 19 patients (39.9 +/- 1.3%) was significantly higher than that in 25 pregnant women (24.6 +/- 10.1%, P = 0.002) and in 25 non-pregnant women (14.8 +/- 5.7%, P = 0.001). In the follow-up of nine patients, when beta-hCG was less than 3.1 ng/ml during the treatment, the BFAR (38.7 +/- 11.9%) decreased below that (44.2 +/- 14.6%) seen prior to treatment (P = 0.009) and was much lower at termination of treatment (27.5 +/- 12.3%, P = 0.048). These data support the use of CDE and the related quantitative analysis as a new method for detecting and follow-up of uterine involvement in patients with trophoblastic tumors.

  19. Effect of varicocele on testicular artery blood flow in men--color Doppler investigation.

    PubMed

    Tarhan, Serdar; Gümüs, Bilali; Gündüz, Ilker; Ayyildiz, Veil; Göktan, Cihan

    2003-01-01

    Varicocele can be defined as an abnormal tortuosity and dilatation of the veins of the pampiniform plexus. Contradictory results have been obtained from experimental animal models and a few clinical human studies on testicular arterial blood flow in varicocele. The purpose of this study was to determine the changes in testicular arterial blood flow parameters in patients with varicocele. A total of 62 patients with a clinical diagnosis of left varicocele and a scrotal vein with a diameter of > or = 3 mm on color Doppler ultrasonography were included in the study. A total of 44 fertile normal male volunteers served as controls. Median testicular arterial blood flow and median flow rate in milliliters per minute per 100 g of testicular tissue were found to be significantly decreased in the patient group compared to the control group: blood flow, 1.42 and 2.00 ml/min; flow rate, 9.63 and 12.35 ml/min/100 g, respectively (p < 0.05). Positive correlations were found between sperm concentration and left testicular artery blood flow (p < 0.05) and between left testicular volume and testicular artery blood flow (p < 0.05). Testicular arterial blood flow was found to be significantly decreased in men with varicocele. This may be a reflection of the impaired microcirculation. Following decreased testicular arterial blood flow, impaired spermatogenesis may result from defective energy metabolism in the microcirculatory bed.

  20. [Apply of RetCam Ⅱ and color Doppler imaging in persistent hyperplastic primary vitreous].

    PubMed

    Han, Mei; Zhao, Kanxing; Zhang, Tongmei; Li, Yan; Gao, Jianmin; Dong, Liu

    2016-05-01

    To observe the manifestations of RetCam Ⅱ and color Doppler imaging (CDI) in a retrospective case series of persistent hyperplastic primary vitreous (PHPV). Retrospective study. The medical records of 9 eyes/9 patients with PHPV went through RetCamⅡ and CDI from 2009 to 2014. There were 6 young boys and 3 young girl in this study, age from 2 months to 5 years. All the patients were born at full term. 9 eyes had complication (cataract). The manifestations of RetCam Ⅱ: There were pale in optic disc. There were white fibre rod connected with optic disc, then prolonged to vitreous cavity, connected with posterior lens capsule. CDI showed arterial blood stream signal in band-shaped echogenic structure within vitreous cavity, prolonged to lens from the optic disc, or showed funnel-shaped echogenic mass at the posterior surface of lens and anterior of vitreous body, adhered to ciliary body, lens and the optic disc. PHPV is congenital ocular anomalies because of a failure of primary vitreous and the hyaloids vascular system to regress. It manifests as unilateral and boys. We diagnosis PHPV by RetCamⅡ and CDI.

  1. Inverse Problem for Color Doppler Ultrasound-Assisted Intracardiac Blood Flow Imaging

    PubMed Central

    Jang, Jaeseong

    2016-01-01

    For the assessment of the left ventricle (LV), echocardiography has been widely used to visualize and quantify geometrical variations of LV. However, echocardiographic image itself is not sufficient to describe a swirling pattern which is a characteristic blood flow pattern inside LV without any treatment on the image. We propose a mathematical framework based on an inverse problem for three-dimensional (3D) LV blood flow reconstruction. The reconstruction model combines the incompressible Navier-Stokes equations with one-direction velocity component of the synthetic flow data (or color Doppler data) from the forward simulation (or measurement). Moreover, time-varying LV boundaries are extracted from the intensity data to determine boundary conditions of the reconstruction model. Forward simulations of intracardiac blood flow are performed using a fluid-structure interaction model in order to obtain synthetic flow data. The proposed model significantly reduces the local and global errors of the reconstructed flow fields. We demonstrate the feasibility and potential usefulness of the proposed reconstruction model in predicting dynamic swirling patterns inside the LV over a cardiac cycle. PMID:27313657

  2. Inverse Problem for Color Doppler Ultrasound-Assisted Intracardiac Blood Flow Imaging.

    PubMed

    Jang, Jaeseong; Ahn, Chi Young; Choi, Jung-Il; Seo, Jin Keun

    2016-01-01

    For the assessment of the left ventricle (LV), echocardiography has been widely used to visualize and quantify geometrical variations of LV. However, echocardiographic image itself is not sufficient to describe a swirling pattern which is a characteristic blood flow pattern inside LV without any treatment on the image. We propose a mathematical framework based on an inverse problem for three-dimensional (3D) LV blood flow reconstruction. The reconstruction model combines the incompressible Navier-Stokes equations with one-direction velocity component of the synthetic flow data (or color Doppler data) from the forward simulation (or measurement). Moreover, time-varying LV boundaries are extracted from the intensity data to determine boundary conditions of the reconstruction model. Forward simulations of intracardiac blood flow are performed using a fluid-structure interaction model in order to obtain synthetic flow data. The proposed model significantly reduces the local and global errors of the reconstructed flow fields. We demonstrate the feasibility and potential usefulness of the proposed reconstruction model in predicting dynamic swirling patterns inside the LV over a cardiac cycle.

  3. The diagnostic value of contrast-enhanced ultrasound in differentiating small renal carcinoma and angiomyolipoma.

    PubMed

    Chen, Lin; Wang, Ling; Diao, Xuehong; Qian, Weiqing; Fang, Liang; Pang, Yun; Zhan, Jia; Chen, Yue

    2015-08-01

    The aim of this study was to explore the value of contrast-enhanced ultrasound (CEUS) in differentiating small renal masses. A total of 102 small renal masses (≤ 3 cm) in 99 patients were examined using conventional ultrasound (CUS) and CEUS, and the findings were reviewed and evaluated in comparison to pathology. Significant differences between renal cell carcinomas (RCCs) and angiomyolipomas (AMLs) were noted in terms of the orientation and echogenicity on CUS (p < 0.05 for both), but the location, shape, margins, homogeneity, and blood flow signals of RCCs on color Doppler flow imaging (CDFI) were similar to those of AMLs (p > 0.05 for all). On CEUS, however, the enhancement intensity, washout in the late phase, and perilesional rim-like enhancement differed significantly for RCCs and AMLs (p = 0.000 for all). Significant differences between CEUS and CUS in terms of sensitivity (88.9% vs. 55.6%), the negative predictive value (68.0% vs. 29.5%), the false negative rate (9.9% vs. 44.5%), and accuracy (88.3% vs. 58.9%) were noted (p < 0.05 for all). CEUS, with its unique features, has value in diagnosing small RCCs and AMLs and outperforms CUS in differentiation of small RCCs and AMLs.

  4. Color Doppler Imaging of the Appendix: Criteria to Improve Specificity for Appendicitis in the Borderline-Size Appendix.

    PubMed

    Xu, Yingding; Jeffrey, R Brooke; Shin, Lewis K; DiMaio, Michael A; Olcott, Eric W

    2016-10-01

    To test the hypothesis that continuous intramural vascular signal measuring at least 3 mm on color Doppler imaging is highly specific for appendicitis in patients with diagnostically borderline-size appendices. Two blinded observers independently reviewed color Doppler images of the appendix in 94 consecutive patients who had undergone sonography for suspected appendicitis and whose appendices were of diagnostically borderline size (6-8 mm maximum outer diameter). Intramural vascular flow on color Doppler images was classified as absent, type 1 (only punctate and dispersed signal), or type 2 (continuous linear or curvilinear signal measuring at least 3.0 mm in long- or short-axis views). Histopathologic examination and clinical follow-up served as reference standards. Proportions were assessed by the exact binomial test. Of the 94 patients, 33 (35.1%) had type 1 flow (of whom 5 [15.2%] had appendicitis); 23 (24.5%) had type 2 flow (of whom 20 [87.0%] had appendicitis); and 38 (40.4%) had absent flow (of whom 10 [26.3%] had appendicitis). The sensitivity, specificity, and odds ratio of type 2 flow as an indicator of appendicitis were 57.1%, 94.9%, and 24.9 (P< .001), respectively; the corresponding values for type 1 flow as an indicator of normal appendices were and 47.5%, 85.7%, and 5.4 (P = .002). Continuous intramural linear or curvilinear signal measuring at least 3 mm on color Doppler imaging is a highly specific, although relatively insensitive, sign of acute appendicitis in noncompressible appendices of diagnostically borderline size (6-8 mm).

  5. Evaluation of a fractional filter-based receive beamforming method for low-cost ultrasound color Doppler imaging

    NASA Astrophysics Data System (ADS)

    Yang, Hana; Kang, Jeeun; Chang, Jin Ho; Yoo, Yangmo

    2012-03-01

    In medical ultrasound imaging, dynamic receive beamforming has been used for improving signal-to-noise ratio (SNR) and spatial resolution. For low-cost portable ultrasound imaging systems, a fractional filter-based receive beamforming (FFRB) method was previously proposed to reduce the hardware complexity compared to conventional interpolation filter-based receive beamforming methods (IFRB). While this new beamforming method substantially reduces the hardware complexity, it yields the nonlinear phase response for high frequencies due to the limited length of fractional filter coefficients, leading to the bias on flow estimation in ultrasound color Doppler imaging. In this paper, to evaluate the FFRB method for ultrasound color Doppler imaging, the Field II simulation and string phantom experiments were conducted. In Field II simulation, the radio-frequency (RF) data were generated by assuming a 7.5-MHz linear array probe with the transmit frequency of 6 MHz, the ensemble size of 8, and the sampling frequencies of 20 MHz. In string phantom experiments, the RF channel data were obtained with a commercial SonixTouch ultrasound scanner equipped with a research package (Ultrasonix Corp., Vancouver, BC, Canada; a 5-MHz linear array connected to a SonixDAQ parallel system. The ensemble size and the sampling frequency were set to 10 and 20 MHz, respectively. For the Field II simulation and string phantom experiments, only 1.2% and 2.3 % in color Doppler estimation error ratio was observed with mean and standard deviation along the lateral direction. This result indicates that the proposed FFRB method could be utilized for a low-cost ultrasound color Doppler imaging system with lowered hardware complexity and minimized phase errors.

  6. Vascular color Doppler ultrasound for assessing renovascular hypertension: accuracy of the direct technique for assessing the renal arteries.

    PubMed

    Engelhorn, Carlos Alberto; Engelhorn, Ana Luiza; Pullig, Renata

    2004-05-01

    To assess the accuracy of vascular color Doppler ultrasound as compared with digital subtraction arteriography for identifying hemodynamically significant renal artery stenoses. One hundred and thirty-seven renal arteries from 69 adult patients suspected of having renovascular arterial hypertension were prospectively studied with ultrasound. The results obtained were compared in a double-blind manner with those obtained on digital subtraction arteriography, and the following parameters were calculated according to previously defined criteria: sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy. The inconclusive results (7 arteries) were excluded. The comparison of the 2 methods in regard to the 130 remaining arteries showed concordant results for 116 (89.2%) arteries and discordant results for 14 (10.8%) arteries. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of vascular color Doppler ultrasound were, respectively, 95.33%, 88.14%, 89.86%, 94.55%, and 91.94%. A good correlation between the 2 examinations was observed in the evaluation of the hemodynamically significant renal artery stenoses, making vascular color Doppler ultrasound a noninvasive method useful for selecting patients with suspected renovascular hypertension.

  7. Computer-aided diagnosis system for breast cancer using B-mode and color Doppler flow images

    NASA Astrophysics Data System (ADS)

    Liu, Yan; Cheng, Heng-Da; Huang, Jianhua; Zhang, Yingtao; Tang, Xianglong; Wang, Hong; Tian, Jiawei

    2012-04-01

    To improve the diagnostic accuracy of breast ultrasound classification, a novel computer-aided diagnosis system based on B-Mode ultrasound and color Doppler flow imaging is proposed. First, different feature extraction methods were used to obtain the texture and geometric features from B-Mode ultrasound images. In the color Doppler feature stage, both vascularity and hemodynamic features are studied by applying color distribution and periodograms analysis to Doppler signals. Finally, a support vector machine classifier with selected feature vectors is used to classify breast tumors into benign and malignant. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and areas under the ROC curves of the proposed system are 94.28%, 96.36%, 92.00%, 92.98%, 95.83%, and 0.9679, respectively. The experimental results demonstrate that the proposed computer-aided diagnosis system can improve the true-positive and decrease the false-positive diagnostic rate, which is useful for reducing the unnecessary biopsy and death rate.

  8. Contrast enhanced ultrasound of breast cancer

    PubMed Central

    Cassano, E; Rizzo, S; Bozzini, A; Menna, S; Bellomi, M

    2006-01-01

    The importance of ultrasound examination in the diagnosis of breast cancer has been widely demonstrated. During the last few years, the introduction of ultrasound contrast media has been considered a promising tool for studying the vascular pattern of focal lesions within the breast. Our purpose was to assess whether contrast-enhanced (CE) ultrasound examination, performed using specific contrast imaging modes, can be helpful for detection and characterization of breast lesions, and for prediction of the response of breast cancer to therapy. PMID:16478698

  9. Contrast-enhanced ultrasonography in the diagnosis of upper urinary tract urothelial cell carcinoma: a preliminary study.

    PubMed

    Drudi, F M; Di Candio, G; Di Leo, N; Malpassini, F; Gnecchi, M; Cantisani, V; Iori, F; Liberatore, M

    2013-02-01

    The main objective was to assess the effectiveness of contrast-enhanced ultrasonography (CEUS) in the diagnosis of upper urinary tract malignancies by comparing with multidetector computed tomographic urography (MDCTU) and magnetic resonance urography (MRU). Secondary objectives were to compare the tumor size measured with CEUS, MDCTU and MRU and to assess the usefulness of CEUS in distinguishing high-grade tumors from low-grade ones. In connection with this prospective study carried out from January 2009 to September 2011, 18 patients underwent MDCTU or MRU, grayscale ultrasonography (US), color Doppler ultrasonography and CEUS followed by surgery and histological examination of the specimen. Quantitative analysis was performed using perfusion software. Time intensity curves were extracted and the following parameters were considered: wash-in time, time-to-peak, maximum signal intensity and wash-out time. Grayscale US identified 15/18 lesions; color Doppler showed no flow signal in 8 lesions, low color signal in 9 lesions and an intense color signal in 1 lesion; CEUS identified 17/18 lesions with the undetected lesion being the smallest one (1.2 cm) located in the upper pelvicalyceal system. Semi-quantitative analysis produced different data for high-grade and low-grade urothelial cell carcinoma (UCC). All detected upper urinary tract masses were UCCs. MRU, MDCTU and grayscale US overestimated the tumor size, while CEUS was the most accurate. CEUS is useful for evaluating upper urinary tract masses as this method permits differentiation between high-grade and low-grade tumors as well as distinction of the tumor from the adjacent structures and accurate mass measurements. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Contrast enhanced ultrasound of sentinel lymph nodes.

    PubMed

    Cui, XinWu; Ignee, Andre; Nielsen, Michael Bachmann; Schreiber-Dietrich, Dagmar; De Molo, Chiara; Pirri, Clara; Jedrzejczyk, Maciej; Christoph, Dietrich F

    2013-03-01

    Sentinel lymph nodes are the first lymph nodes in the region that receive lymphatic drainage from a primary tumor. The detection or exclusion of sentinel lymph node micrometastases is critical in the staging of cancer, especially breast cancer and melanoma because it directly affects patient's prognosis and surgical management. Currently, intraoperative sentinel lymph node biopsies using blue dye and radioisotopes are the method of choice for the detection of sentinel lymph node with high identification rate. In contrast, conventional ultrasound is not capable of detecting sentinel lymph nodes in most cases. Contrast enhanced ultrasound with contrast specific imaging modes has been used for the evaluation and diagnostic work-up of peripherally located suspected lymphadenopathy. The method allows for real-time analysis of all vascular phases and the visualization of intranodal focal "avascular" areas that represent necrosis or deposits of neoplastic cells. In recent years, a number of animal and human studies showed that contrast enhanced ultrasound can be also used for the detection of sentinel lymph node, and may become a potential application in clinical routine. Several contrast agents have been used in those studies, including albumin solution, hydroxyethylated starch, SonoVue(®), Sonazoid(®) and Definity(®). This review summarizes the current knowledge about the use of ultrasound techniques in detection and evaluation of sentinel lymph node.

  11. Fast contrast enhanced imaging with projection reconstruction

    NASA Astrophysics Data System (ADS)

    Peters, Dana Ceceilia

    The use of contrast agents has lead to great advances in magnetic resonance angiography (MRA). Here we present the first application of projection reconstruction to contrast enhanced MRA. In this research the limited angle projection reconstruction (PR) trajectory is implemented to acquire higher resolution images per unit time than with conventional Fourier transform (FT) imaging. It is well known that as FOV is reduced in conventional spin- warp imaging, higher resolution per unit time can be obtained, but aliasing may appear as a replication of outside material within the FOV. The limited angle PR acquisition also produces aliasing artifacts. This method produced artifacts which were unacceptable in X-ray CT but which appear to be tolerable in MR Angiography. Resolution throughout the FOV is determined by the projection readout resolution and not by the number of projections. As the number of projections is reduced, the resolution is unchanged, but low intensity artifacts appear. Here are presented the results of using limited angle PR in phantoms and contrast-enhanced angiograms of humans.

  12. Quantitative contrast-enhanced optical coherence tomography

    PubMed Central

    Winetraub, Yonatan; SoRelle, Elliott D.; Liba, Orly; de la Zerda, Adam

    2016-01-01

    We have developed a model to accurately quantify the signals produced by exogenous scattering agents used for contrast-enhanced Optical Coherence Tomography (OCT). This model predicts distinct concentration-dependent signal trends that arise from the underlying physics of OCT detection. Accordingly, we show that real scattering particles can be described as simplified ideal scatterers with modified scattering intensity and concentration. The relation between OCT signal and particle concentration is approximately linear at concentrations lower than 0.8 particle per imaging voxel. However, at higher concentrations, interference effects cause signal to increase with a square root dependence on the number of particles within a voxel. Finally, high particle concentrations cause enough light attenuation to saturate the detected signal. Predictions were validated by comparison with measured OCT signals from gold nanorods (GNRs) prepared in water at concentrations ranging over five orders of magnitude (50 fM to 5 nM). In addition, we validated that our model accurately predicts the signal responses of GNRs in highly heterogeneous scattering environments including whole blood and living animals. By enabling particle quantification, this work provides a valuable tool for current and future contrast-enhanced in vivo OCT studies. More generally, the model described herein may inform the interpretation of detected signals in modalities that rely on coherence-based detection or are susceptible to interference effects. PMID:26869724

  13. Optimization of subcutaneous vein contrast enhancement

    NASA Astrophysics Data System (ADS)

    Zeman, Herbert D.; Lovhoiden, Gunnar; Deshmukh, Harshal

    2000-05-01

    A technique for enhancing the contrast of subcutaneous veins has been demonstrated. This techniques uses a near IR light source and one or more IR sensitive CCD TV cameras to produce a contrast enhanced image of the subcutaneous veins. This video image of the veins is projected back onto the patient's skin using a n LCD video projector. The use of an IR transmitting filter in front of the video cameras prevents any positive feedback from the visible light from the video projector from causing instabilities in the projected image. The demonstration contrast enhancing illuminator has been tested on adults and children, both Caucasian and African-American, and it enhances veins quite well in all cases. The most difficult cases are those where significant deposits of subcutaneous fat are present which make the veins invisible under normal room illumination. Recent attempts to see through fat using different IR wavelength bands and both linearly and circularly polarized light were unsuccessful. The key to seeing through fat turns out to be a very diffuse source of RI light. Results on adult and pediatric subjects are shown with this new IR light source.

  14. Quantitative contrast-enhanced optical coherence tomography

    SciTech Connect

    Winetraub, Yonatan; SoRelle, Elliott D.; Liba, Orly; Zerda, Adam de la

    2016-01-11

    We have developed a model to accurately quantify the signals produced by exogenous scattering agents used for contrast-enhanced Optical Coherence Tomography (OCT). This model predicts distinct concentration-dependent signal trends that arise from the underlying physics of OCT detection. Accordingly, we show that real scattering particles can be described as simplified ideal scatterers with modified scattering intensity and concentration. The relation between OCT signal and particle concentration is approximately linear at concentrations lower than 0.8 particle per imaging voxel. However, at higher concentrations, interference effects cause signal to increase with a square root dependence on the number of particles within a voxel. Finally, high particle concentrations cause enough light attenuation to saturate the detected signal. Predictions were validated by comparison with measured OCT signals from gold nanorods (GNRs) prepared in water at concentrations ranging over five orders of magnitude (50 fM to 5 nM). In addition, we validated that our model accurately predicts the signal responses of GNRs in highly heterogeneous scattering environments including whole blood and living animals. By enabling particle quantification, this work provides a valuable tool for current and future contrast-enhanced in vivo OCT studies. More generally, the model described herein may inform the interpretation of detected signals in modalities that rely on coherence-based detection or are susceptible to interference effects.

  15. MRI contrast enhancement using Magnetic Carbon Nanoparticles

    NASA Astrophysics Data System (ADS)

    Chaudhary, Rakesh P.; Kangasniemi, Kim; Takahashi, Masaya; Mohanty, Samarendra K.; Koymen, Ali R.; Department of Physics, University of Texas at Arlington Team; University of Texas Southwestern Medical Center Team

    2014-03-01

    In recent years, nanotechnology has become one of the most exciting forefront fields in cancer diagnosis and therapeutics such as drug delivery, thermal therapy and detection of cancer. Here, we report development of core (Fe)-shell (carbon) nanoparticles with enhanced magnetic properties for contrast enhancement in MRI imaging. These new classes of magnetic carbon nanoparticles (MCNPs) are synthesized using a bottom-up approach in various organic solvents, using the electric plasma discharge generated in the cavitation field of an ultrasonic horn. Gradient echo MRI images of well-dispersed MCNP-solutions (in tube) were acquired. For T2 measurements, a multi echo spin echo sequence was performed. From the slope of the 1/T2 versus concentration plot, the R2 value for different CMCNP-samples was measured. Since MCNPs were found to be extremely non-reactive, and highly absorbing in NIR regime, development of carbon-based MRI contrast enhancement will allow its simultaneous use in biomedical applications. We aim to localize the MCNPs in targeted tissue regions by external DC magnetic field, followed by MRI imaging and subsequent photothermal therapy.

  16. Quantitative contrast-enhanced optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Winetraub, Yonatan; SoRelle, Elliott D.; Liba, Orly; de la Zerda, Adam

    2016-01-01

    We have developed a model to accurately quantify the signals produced by exogenous scattering agents used for contrast-enhanced Optical Coherence Tomography (OCT). This model predicts distinct concentration-dependent signal trends that arise from the underlying physics of OCT detection. Accordingly, we show that real scattering particles can be described as simplified ideal scatterers with modified scattering intensity and concentration. The relation between OCT signal and particle concentration is approximately linear at concentrations lower than 0.8 particle per imaging voxel. However, at higher concentrations, interference effects cause signal to increase with a square root dependence on the number of particles within a voxel. Finally, high particle concentrations cause enough light attenuation to saturate the detected signal. Predictions were validated by comparison with measured OCT signals from gold nanorods (GNRs) prepared in water at concentrations ranging over five orders of magnitude (50 fM to 5 nM). In addition, we validated that our model accurately predicts the signal responses of GNRs in highly heterogeneous scattering environments including whole blood and living animals. By enabling particle quantification, this work provides a valuable tool for current and future contrast-enhanced in vivo OCT studies. More generally, the model described herein may inform the interpretation of detected signals in modalities that rely on coherence-based detection or are susceptible to interference effects.

  17. Photonic crystal slabs for surface contrast enhancement in microscopy of transparent objects.

    PubMed

    Nazirizadeh, Yousef; Becker, Tim; Reverey, Julia; Selhuber-Unkel, Christine; Rapoport, Daniel H; Lemmer, Uli; Gerken, Martina

    2012-06-18

    In optical microscopy the contrast of transparent objects achieved with conventional methods is often not satisfactory, for example for the automated recognition of cells. In this paper we present a nano-optical label-free approach for contrast enhancement based on photonic crystal slabs (PCS) as the specimen holder. Quasi-guided modes inside these structures cause an intrinsic color of the PCS, which strongly depends on the wavelength and the quality factor of the optical mode. Objects on the surface of the PCS experience a significant color and intensity contrast enhancement, as they change properties of the optical modes.

  18. Adaptive clutter rejection for 3D color Doppler imaging: preliminary clinical study.

    PubMed

    Yoo, Yang Mo; Sikdar, Siddhartha; Karadayi, Kerem; Kolokythas, Orpheus; Kim, Yongmin

    2008-08-01

    In three-dimensional (3D) ultrasound color Doppler imaging (CDI), effective rejection of flash artifacts caused by tissue motion (clutter) is important for improving sensitivity in visualizing blood flow in vessels. Since clutter characteristics can vary significantly during volume acquisition, a clutter rejection technique that can adapt to the underlying clutter conditions is desirable for 3D CDI. We have previously developed an adaptive clutter rejection (ACR) method, in which an optimum filter is dynamically selected from a set of predesigned clutter filters based on the measured clutter characteristics. In this article, we evaluated the ACR method with 3D in vivo data acquired from 37 kidney transplant patients clinically indicated for a duplex ultrasound examination. We compared ACR against a conventional clutter rejection method, down-mixing (DM), using a commonly-used flow signal-to-clutter ratio (SCR) and a new metric called fractional residual clutter area (FRCA). The ACR method was more effective in removing the flash artifacts while providing higher sensitivity in detecting blood flow in the arcuate arteries and veins in the parenchyma of transplanted kidneys. ACR provided 3.4 dB improvement in SCR over the DM method (11.4 +/- 1.6 dB versus 8.0 +/- 2.0 dB, p < 0.001) and had lower average FRCA values compared with the DM method (0.006 +/- 0.003 versus 0.036 +/- 0.022, p < 0.001) for all study subjects. These results indicate that the new ACR method is useful for removing nonstationary tissue motion while improving the image quality for visualizing 3D vascular structure in 3D CDI.

  19. Early diagnosis and outcome prediction of neonatal hypoxic-ischemic encephalopathy with color Doppler ultrasound.

    PubMed

    Guan, B; Dai, C; Zhang, Y; Zhu, L; He, X; Wang, N; Liu, H

    2017-06-01

    To describe the ultrasound presentation of the brain and cerebral hemodynamics in neonates with hypoxic-ischemic encephalopathy (HIE) by comparison with control subjects. During June 2012 to April 2013, full term neonates who had clinical evidence of HIE were enrolled. Healthy newborns without HIE were used as a control group. Cerebral parenchyma, size of lateral ventricles and hemodynamic parameters of cerebral arteries were studied using two-dimensional duplex and color Doppler ultrasound. Neonates with moderate and severe HIE were followed-up with ultrasound for at least 3 months. A total of 158 consecutive neonates (82 boys and 76 girls), including 54 with mild HIE, 60 with moderate HIE and 44 with severe HIE were included. One hundred and twenty healthy newborns were randomly selected as a control group. Abnormal ultrasound findings of brain parenchyma were found in 25/54 (46.3%) neonates with mild HIE whereas they were found in 58/60 (96.7%) neonates with moderate HIE and 44/44 (100%) neonates with severe HIE. Almost all neonates with severe HIE had decreased cerebral artery blood flow velocity and increased resistance index of cerebral arteries. Of the 104 neonates with moderate or severe HIE, follow-up ultrasound examination revealed cystic parenchymal lesions in 12/104 (11.5%), progressive ventricular dilatation and brain atrophy in 12/104 (11.5%), mild ventricular dilatation in 15/104 (14.4%) and leukoencephalomalacia in 2/104 (1.9%) neonates. Ultrasound features such as the size of lateral ventricles, altered brain parenchymal echogenicity and cerebral blood flow parameters are useful for the early diagnosis of HIE and help predict outcome. Copyright © 2016 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  20. Using dynamic infrared thermography to optimize color Doppler ultrasound mapping of cutaneous perforators.

    PubMed

    Muntean, Maximilian Vlad; Strilciuc, Stefan; Ardelean, Filip; Pestean, Cosmin; Lacatus, Radu; Badea, Alexandru Florin; Georgescu, Alexandru

    2015-12-01

    The high technical demands associated with perforator flaps demand a precise preoperative identification and evaluation of perforator vessels. Color Doppler Ultrasonography (CDU) and Dynamic Infrared Thermography (DIRT) are currently used for preoperative perforator mapping. Each individual technique has advantages and disadvantages. The purpose of this paper is to analyze the value of combining the two methods in order to optimize the process of preoperative perforator mapping. CDU and DIRT were used for preoperative perforator mapping in 10 pigs. The results were compared to intraoperative findings. Total number of perforators, localization, and identification of the dominant perforator was analyzed for each method. The examination time was recorded for each procedure. Both methods had a high sensitivity in determining the number and localization of perforators when compared to those identified during surgery. DIRT produced a higher number of false positive results. CDU accurately identified the emergence of the perforators in the fascia in all cases. Both methods correctly identified the dominant perforator. The sensitivity, positive predictive value, and accuracy of CDU were 93.56%, 97%, and 91.30% respectively and for DIRT 95.05%, 80.67%, and 77.41% respectively. The average examination was 39.76 minutes for CDU and 10.24 minutes for DIRT. The average time taken into account for the analysis of a single perforator in order to confirm DIRT findings was 1.83 minutes. Preoperative perforator mapping has become a compulsory step in nearly all reconstructive procedures. In our study, both CDU and DIRT correctly identified the dominant perforator in all cases. By combining the two examinations overall mapping time can be reduced significantly. A reduced examination time translates into increased patient compliance and a lower procedure cost. The combined mapping technique facilitates the selection of the ideal perforator in all cases. Correctly identifying the

  1. Color Doppler ultrasound and gamma imaging of intratumorally injected 500 nm iron-silica nanoshells.

    PubMed

    Liberman, Alexander; Wu, Zhe; Barback, Christopher V; Viveros, Robert; Blair, Sarah L; Ellies, Lesley G; Vera, David R; Mattrey, Robert F; Kummel, Andrew C; Trogler, William C

    2013-07-23

    Perfluoropentane gas filled iron-silica nanoshells have been developed as stationary ultrasound contrast agents for marking tumors to guide surgical resection. It is critical to establish their long-term imaging efficacy, as well as biodistribution. This work shows that 500 nm Fe-SiO2 nanoshells can be imaged by color Doppler ultrasound over the course of 10 days in Py8119 tumor bearing mice. The 500 nm nonbiodegradable SiO2 and biodegradable Fe-SiO2 nanoshells were functionalized with diethylenetriamine pentaacetic acid (DTPA) ligand and radiolabeled with (111)In(3+) for biodistribution studies in nu/nu mice. The majority of radioactivity was detected in the liver and kidneys following intravenous (IV) administration of nanoshells to healthy animals. By contrast, after nanoshells were injected intratumorally, most of the radioactivity remained at the injection site; however, some nanoshells escaped into circulation and were distributed similarly as those given intravenously. For intratumoral delivery of nanoshells and IV delivery to healthy animals, little difference was seen between the biodistribution of SiO2 and biodegradable Fe-SiO2 nanoshells. However, when nanoshells were administered IV to tumor bearing mice, a significant increase was observed in liver accumulation of SiO2 nanoshells relative to biodegradable Fe-SiO2 nanoshells. Both SiO2 and Fe-SiO2 nanoshells accumulate passively in proportion to tumor mass, during intravenous delivery of nanoshells. This is the first report of the biodistribution following intratumoral injection of any biodegradable silica particle, as well as the first report demonstrating the utility of DTPA-(111)In labeling for studying silica nanoparticle biodistributions.

  2. Real-time Feedback of Histotripsy Thrombolysis Using Bubble-induced Color Doppler

    PubMed Central

    Zhang, Xi; Miller, Ryan M.; Lin, Kuang-Wei; Levin, Albert M.; Owens, Gabe E.; Gurm, Hitinder S.; Cain, Charles A.; Xu, Zhen

    2014-01-01

    Histotripsy thrombolysis is a noninvasive, drug-free and image-guided therapy that fractionates blood clots using well-controlled acoustic cavitation alone. Real-time quantitative feedback is highly desired during histotripsy thrombolysis treatment to monitor the progress of clot fractionation. Bubble-induced color Doppler (BCD) monitors the motion following cavitation generated by each histotripsy pulse, which has been shown in gel and ex vivo liver tissue to be correlated with histotripsy fractionation. In this paper we investigate the potential of BCD to quantitatively monitor histotripsy thrombolysis in real-time. To visualize clot fractionation, transparent three-layered fibrin clots were developed. Results show a coherent motion follows the cavitation generated by each histotripsy pulse with a push and rebound pattern. The temporal profile of this motion expanded and saturated as the treatment progressed. A strong correlation existed between the degree of histotripsy clot fractionation and two metrics extracted from BCD: time of peak rebound velocity (tPRV) and focal mean velocity at a fixed delay (Vf,delay). The saturation of clot fractionation (i.e., treatment completion) matched well with the saturations detected using tPRV and Vf,delay. The mean Pearson correlation coefficients between the progressions of clot fractionation and the two BCD metrics were 93.1% and 92.6% respectively. To validate the BCD feedback in in vitro clots, debris volume from histotripsy thrombolysis were obtained at different therapy doses and compared with Vf,delay. The increasing and saturation trends of debris volume and Vf,delay also had good agreement. Finally, a real-time BCD feedback algorithm to predict complete clot fractionation during histotripsy thrombolysis was developed and tested. This work demonstrated the potential of BCD to monitor histotripsy thrombolysis treatment in real-time. PMID:25623821

  3. Color Doppler Ultrasonography-Targeted Perforator Mapping and Angiosome-Based Flap Reconstruction.

    PubMed

    Gunnarsson, Gudjon Leifur; Tei, Troels; Thomsen, Jørn Bo

    2016-10-01

    Knowledge about perforators and angiosomes has inspired new and innovative flap designs for reconstruction of defects throughout the body. The purpose of this article is to share our experience using color Doppler ultrasonography (CDU)-targeted perforator mapping and angiosome-based flap reconstruction throughout the body. The CDU was used to identify the largest and best-located perforator adjacent to the defect to target the reconstruction. The cutaneous or fasciocutaneous flaps were raised, mobilized, and designed according to the reconstructive needs as rotation, advancement, or turnover flaps. We performed 148 reconstructions in 130 patients. Eleven facial reconstructions, 118 reconstructions in the body, 7 in the upper limbs, and 12 in the lower limbs. The propeller flap was used in 135 of 148 (91%) cases followed by the turnover design in 10 (7%) and the V to Y flap in 3 (2%) cases. The flaps were raised on 1 perforator in 98 (67%), 2 perforators in 48 (33%), and 3 perforators in 2 (1%) flaps. The reconstructive goal was achieved in 143 of 148 reconstructions (97%). In 5 cases, surgical revision was needed. No flaps were totally lost indicating a patent pedicle in all cases. We had 10 (7%) cases of major complications and 22 (15%) minor complications. The CDU-targeted perforator mapping and angiosome-based flap reconstruction are simple to perform, and we recommended its use for freestyle perforator flap reconstruction. All perforators selected by CDU was identified during surgery and used for reconstruction. The safe boundaries of angiosomes remain to be established.

  4. Gray-scale and color Doppler ultrasonographic manifestations of papillary thyroid carcinoma: analysis of 51 cases.

    PubMed

    Yuan, Wei-Hsin; Chiou, Hong-Jen; Chou, Yi-Hong; Hsu, Hui-Chen; Tiu, Chui-Mei; Cheng, Chang-Yen; Lee, Chen-Hsen

    2006-01-01

    The purpose of this study is to assess the specific ultrasonic characteristics of papillary thyroid carcinoma and to determine the relative frequency of various patterns of papillary carcinoma on gray-scale ultrasonography (US) and color Doppler ultrasonography (CDU). We retrospectively reviewed US features in 51 patients with confirmed papillary thyroid carcinoma. The features were analyzed based on tumor size, echogenicity, echotexture, boundary, margin, shape, and calcification pattern on gray-scale US imaging, and on patterns of vascularity on CDU. We obtained the relative frequency of features and classified these features into three categories: common (> or =50% of lesions), less common (>10% but <50%), and uncommon (< or =10%). Individual differences and combinations of features were also analyzed. In total, 67 nodules were enrolled in our study. The sizes of 76% of nodular lesions were <20.0 mm. Common US features of papillary carcinoma included: a homogeneous hypoechoic solid picture; a poorly defined boundary; an irregular margin; the absence of halo; the absence of calcifications or microcalcifications; and mixed perinodular and intranodular blood flow patterns. Less common features included: a heterogeneous hypoechoic or very hypoechoic picture; microcalcifications; a well-defined boundary; a regular margin; a halo with uneven thickness or an incomplete halo; and a taller-than-wide shape. Uncommon features included: an isoechoic picture; solid with cystic components; coarse calcifications; mixed coarse calcifications and microcalcifications; "inferno"-type blood flow; and absence of blood flow. On average, each nodule had 4.9 US features considered common, 1.8 US features considered less common, and 0.4 US feature considered uncommon. Features such as predominantly cystic composition, hyperechoic texture, and hypoechoic halo with even thickness were never found in our study. The top two common manifestations of papillary carcinoma were solid

  5. Adaptive sigmoid function bihistogram equalization for image contrast enhancement

    NASA Astrophysics Data System (ADS)

    Arriaga-Garcia, Edgar F.; Sanchez-Yanez, Raul E.; Ruiz-Pinales, Jose; Garcia-Hernandez, Ma. de Guadalupe

    2015-09-01

    Contrast enhancement plays a key role in a wide range of applications including consumer electronic applications, such as video surveillance, digital cameras, and televisions. The main goal of contrast enhancement is to increase the quality of images. However, most state-of-the-art methods induce different types of distortion such as intensity shift, wash-out, noise, intensity burn-out, and intensity saturation. In addition, in consumer electronics, simple and fast methods are required in order to be implemented in real time. A bihistogram equalization method based on adaptive sigmoid functions is proposed. It consists of splitting the image histogram into two parts that are equalized independently by using adaptive sigmoid functions. In order to preserve the mean brightness of the input image, the parameter of the sigmoid functions is chosen to minimize the absolute mean brightness metric. Experiments on the Berkeley database have shown that the proposed method improves the quality of images and preserves their mean brightness. An application to improve the colorfulness of images is also presented.

  6. Value of high resolution compression elastography and color doppler sonography in characterisation of breast lesions: comparison of different high-frequency transducers.

    PubMed

    Rjosk-Dendorfer, D; Gürtler, V M; Sommer, W H; Reiser, M; Clevert, D A

    2014-01-01

    To evaluate the additional effect of higher frequent linear probes than 12.5 MHz in color Doppler sonography and free hand sonoelastography of benign and malignant breast masses and to compare different color encodings in sonoelastography. From December 2012 to March 2013, 37 patients with benign or malignant breast masses were prospectively included in this study. All solid masses have been histologically proven. Two readers assessed sonoelastographic findings at 12.5 MHz vs. 17 MHz according to the tsukuba elasticity score and additionally different color encodings were compared. Results of Doppler sonography using a score of 0, 1 or 2, depending on the degree of perfusion, also were assessed at 12.5 MHz vs. 17 MHz. Among the 37 examined breast masses there were 10 cysts, 16 fibroadenomas and 11 carcinomas. Median participant age was 49.0 years. Use of color Doppler sonography enabled to distinguish cysts from solid breast masses (p < 0.001), without an improvement at 17 MHz. Additional sonoelastography significantly improved the specificity in solid breast masses (p < 0.001). No changes could be seen using different colors in sonoelastography. Combination of color Doppler sonography and sonoelastography can increase the accuracy in distinguishing benign from malignant breast masses. The use of linear probes with a higher frequency than 12.5 MHz does not show any benefit, neither in color Doppler sonography nor in sonoelastography.

  7. Basal ganglia perfusion using dynamic color Doppler sonography in infants with hypoxic ischemic encephalopathy receiving therapeutic hypothermia: a pilot study

    PubMed Central

    Cassia, Guilherme; Morneault, Linda; Saint-Martin, Christine; Sant’Anna, Guilherme

    2016-01-01

    Background The objective of this study was to evaluate the cerebral perfusion of the basal ganglia in infants with hypoxic-ischemic encephalopathy (HIE) receiving hypothermia using dynamic color Doppler sonography (CDS) and investigate for any correlation between these measurements and survival. Methods Head ultrasound (HUS) was performed with a 9S4 MHz sector transducer in HIE infants submitted to hypothermia as part of their routine care. Measurements of cerebral perfusion intensity (CPI) with an 11LW4 MHz linear array transducer were performed to obtain static images and DICOM color Doppler videos of the blood flow in the basal ganglia area. Clinical and radiological data were evaluated retrospectively. The video images were analyzed by two radiologists using dedicated software, which allows automatic quantification of color Doppler data from a region of interest (ROI) by dynamically assessing color pixels and flow velocity during the heart cycle. CPI is expressed in cm/sec and is calculated by multiplying the mean velocity of all pixels divided by the area of the ROI. Three videos of 3 seconds each were obtained of the ROI, in the coronal plane, and used to calculate the CPI. Data are presented as mean ± SEM or median (quartiles). Results A total of 28 infants were included in this study: 16 male, 12 female. HUS was performed within the first 48 hours of therapeutic hypothermia treatment. CPI values were significantly higher in the seven non-survivors when compared to survivors (0.226±0.221 vs. 0.111±0.082 cm/sec; P=0.02). Conclusions Increased perfusion intensity of the basal ganglia area within the first 48 of therapeutic hypothermia treatment was associated with poor outcome in neonates with HIE. PMID:27942470

  8. Contrast-Enhanced Digital Mammography and Angiogenesis

    SciTech Connect

    Rosado-Mendez, I.; Palma, B. A.; Villasenor, Y.; Benitez-Bribiesca, L.; Brandan, M. E.

    2007-11-26

    Angiogenesis could be a means for pouring contrast media around tumors. In this work, optimization of radiological parameters for contrast-enhanced subtraction techniques in mammography has been performed. A modification of Lemacks' analytical formalism was implemented to model the X-ray absorption in the breast with contrast medium and detection by a digital image receptor. Preliminary results of signal-to-noise ratio analysis show the advantage of subtracting two images taken at different energies, one prior and one posterior to the injection of contrast medium. Preliminary experimental results using a custom-made phantom have shown good agreement with calculations. A proposal is presented for the clinical application of the optimized technique, which aims at finding correlations between angiogenesis indicators and dynamic variables of contrast medium uptake.

  9. Combination of pulsed-wave Doppler and real-time three-dimensional color Doppler echocardiography for quantifying the stroke volume in the left ventricular outflow tract.

    PubMed

    Tsujino, Hiroyuki; Jones, Michael; Qin, Jian Xin; Sitges, Marta; Cardon, Lisa A; Morehead, Annitta L; Zetts, Arthur D; Bauer, Fabrice; Kim, Yong Jin; Hang, Xi Yi; Greenberg, Neil; Thomas, James D; Shiota, Takahiro

    2004-11-01

    Real-time three-dimensional (3-D) color Doppler echocardiography (RT3D) is capable of quantifying flow. However, low temporal resolution limits its application to stroke volume (SV) measurements. The aim of the present study was, therefore, to develop a reliable method to quantify SV. In animal experiments, cross-sectional images of the LV outflow tract were selected from the RT3D data to calculate peak flow rates (Q(p3D)). Conventional pulsed-wave (PW) Doppler was performed to measure the velocity-time integral (VTI) and the peak velocity (V(p)). By assuming that the flow is proportional to the velocity temporal waveform, SV was calculated as alpha x Q(p3D) x VTI/V(p), where alpha is a temporal correction factor. There was an excellent correlation between the reference flow meter and RT3D SV (mean difference = -1. 3 mL, y = 1. 05 x -2. 5, r = 0. 94, p < 0. 01). The new method allowed accurate SV estimations without any geometric assumptions of the spatial velocity distributions.

  10. Image analysis of placental issues using three-dimensional ultrasound and color power Doppler based on Support Vector Machine

    NASA Astrophysics Data System (ADS)

    Wang, Qi; Xu, Diyun; Liu, Jianguo

    2009-10-01

    With the development of medical science, three-dimensional ultrasound and color power Doppler tomography shooting placenta is widely used. To determine whether the fetus's development is abnormal or not is mainly through the analysis of the capillary's distribution of the obtained images which are shot by the Doppler scanner. In this classification process, we will adopt Support Vector Machine classifier. SVM achieves substantial improvements over the statistical learning methods and behaves robustly over a variety of different learning tasks. Furthermore, it is fully automatic, eliminating the need for manual parameter tuning and can solve the small sample problem wonderfully well. So SVM classifier is valid and reliable in the identification of placentas and is more accurate with the lower error rate.

  11. Estimation of two-dimensional intraventricular velocity and pressure maps by digital processing conventional color-Doppler sequences

    NASA Astrophysics Data System (ADS)

    Garcia, Damien; Del Alamo, Juan C.; Tanne, David; Cortina, Cristina; Yotti, Raquel; Fernandez-Aviles, Francisco; Bermejo, Javier

    2008-11-01

    Clinical echocardiographic quantification of blood flow in the left ventricle is limited because Doppler methods only provide one velocity component. We developed a new technique to obtain two-dimensional flow maps from conventional transthoracic echocardiographic acquisitions. Velocity and pressure maps were calculated from color-Doppler velocity (apical long-axis view) by solving the continuity and Euler equations under the assumptions of zero transverse fluxes of mass and momentum. This technique is fast, clinically-compliant and does not require any specific training. Particle image velocimetry experiments performed in an atrioventricular duplicator showed that the circulation and size of the diastolic vortex was quantified accurately. Micromanometer measurements in pigs showed that apex-base pressure differences extracted from two-dimensional maps qualitatively agreed with micromanometer data. Initial clinical measurements in healthy volunteers showed a large prograde vortex. Additional retrograde vortices appeared in patients with dilated cardiomyopathy and left ventricular hypertrophy.

  12. Role of contrast-enhanced ultrasound (CEUS) in the diagnosis of endometrial pathology

    PubMed Central

    POP, CIPRIAN MIHAITA; MIHU, DAN; BADEA, RADU

    2015-01-01

    Ultrasound is the reference imaging procedure used for the exploration of endometrial pathology. As medical procedures improve and the requirements of modern medicine become more demanding, gray-scale ultrasound is insufficient in establishing gynecological diagnosis. Thus, more complex examination techniques are required: Doppler ultrasound, contrast-enhanced ultrasound (CEUS), 3D ultrasound, etc. Contrast-enhanced ultrasound is a special examination technique that gains more and more ground. This allows a detailed real-time evaluation of microcirculation in a certain territory, which is impossible to perform by Doppler ultrasound. The aim of this review is to synthesize current knowledge regarding CEUS applications in endometrial pathology, to detail the technical aspects of endometrial CEUS and the physical properties of the equipment and contrast agents used, as well as to identify the limitations of the method. PMID:26733740

  13. Carotid endarterectomy versus stenting: Does the flow really change? An Echo-Color-Doppler analysis.

    PubMed

    Lucatelli, Pierleone; Fanelli, Fabrizio; Cirelli, Carlo; Sacconi, Beatrice; Anzidei, Michele; Montisci, Roberto; Sanfilippo, Roberto; Tamponi, Elisabetta; Catalano, Carlo; Saba, Luca

    2015-04-01

    To assess potential hemodynamic differences after carotid endarterectomy (CEA) and carotid artery stenting (CAS) and their eventual impact on clinical management. Between July 2012 and October 2013 two groups of 30 patients each referred for CEA or CAS were prospectively enrolled in two tertiary hospital care centers. Pre-procedural imaging assessment of carotid artery disease was performed with Echo-Color-Doppler (ECD) and computed tomography angiography (CTA). ECD was repeated within 24 h and 1, 6 and 12 months after surgical/endovascular procedures. Peak systolic velocity (PSV) and end diastolic velocity (EDV) were assessed at two standard sites: common carotid artery (CCA) and distal internal carotid artery (ICA). Twenty-four hours ECD findings highly differ between the two populations. CCA PSV in the CEA and CAS groups was respectively 44.88 ± 9.16 and 69.20 ± 20.04 cm/s (p = 0.002); CCA EDV was 16.11 ± 2.29 and 19.13 ± 6.42 cm/s (p = 0.065); ICA PSV was 46.11 ± 7.9 and 94.02 ± 57.7 cm/s (p = 0.0012); ICA EDV was 20.22 ± 4.33 and 30.47 ± 18.33 cm/s (p = 0.025). One month, 6 months and 1 year findings confirmed the different trend in the two cohorts; in particular, at 1 year: CCA PSV was 50.94 ± 12.44 and 60.59 ± 26.84 cm/s (p = 0.181); CCA EDV was 17.11 ± 3.46 and 19 ± 16.35 cm/s (p = 0.634); ICA PSV was 51.66 ± 10.1 and 70.86 ± 20.64 cm/s (p = 0.014); ICA EDV was 25.05 ± 8.65 and 32.66 ± 13 cm/s (p = 0.0609). ECD follow-up of patients undergone CEA or CAS may play a critical role in the clinical management. Strict surveillance of blood flow velocities allows reducing false positive re-stenosis diagnosis and choosing the best anti-aggregation therapies. Within the first month CEA patients benefit from a lower risk condition in comparison with CAS patients, due to a significantly faster PSV drop; moreover, long-term CCA PSV after CEA could be used as a surrogate marker of neointima formation.

  14. Revascularization alone or combined with suture annuloplasty for ischemic mitral regurgitation. Evaluation by color Doppler echocardiography.

    PubMed Central

    Czer, L S; Maurer, G; Bolger, A F; DeRobertis, M; Chaux, A; Matloff, J M

    1996-01-01

    To determine the effectiveness of revascularization alone or combined with mitral valve repair for ischemic mitral regurgitation, we performed color Doppler echocardiography intraoperatively before and after cardiopulmonary bypass in 49 patients (mean age, 70 +/- 9 years) with concomitant mitral regurgitation and coronary artery disease (triple vessel or left main in 88%; prior infarction in 90%). After revascularization alone (n = 25), the mitral annulus diameter (2.88 +/- 0.44 cm vs 2.88 +/- 0.44 cm), leaflet-to-annulus ratio (1.44 +/- 0.30 vs 1.44 +/- 0.29), and mitral regurgitation grade (1.7 +/- 0.9 vs 1.8 +/- 0.7) remained unchanged (p = NS, postpump vs prepump); mitral regurgitation decreased by 2 grades in only 1 patient (4%). After combined revascularization and mitral valve suture annuloplasty (Kay-Zubiate; n = 24), the annulus diameter decreased (to 2.57 +/- 0.45 cm from 3.11 +/- 0.43 cm), the leaflet-to-annulus ratio increased (to 1.46 +/- 0.25 from 1.20 +/- 0.21), and the mitral regurgitation grade decreased significantly (to 0.9 +/- 0.9 from 2.8 +/- 1.0) (p < 0.01); mitral regurgitation decreased by 2 grades or more (successful repair) in 75%. The origin of the jet correlated with the site of prior infarction (p < 0.05), being inferior in cases of posterior or inferior infarction (67%), and central or broad in cases of combined anterior and inferior infarction (70%). Despite a slightly higher 30-day mortality in the repair group (p = 0.10), there was no significant difference in survival between the 2 surgical groups at 5 years or 8 years. Therefore, in this study of patients with mitral regurgitation and coronary artery disease, reduction in regurgitation grade with revascularization alone was infrequent. Concomitant suture annuloplasty significantly reduced regurgitation by reestablishing a more normal relationship between the leaflet and annulus sizes. The failure rate after suture annuloplasty was 25%; alternative repair techniques such as ring

  15. Color Doppler Ultrasound in Diagnosis and Assessment of Carotid Body Tumors: Comparison with Computed Tomography Angiography.

    PubMed

    Jin, Zhan-Qiang; He, Wen; Wu, Dong-Fang; Lin, Mei-Ying; Jiang, Hua-Tang

    2016-09-01

    A carotid body tumor (CBT) is a rare, non-chromaffin paraganglioma, and its diagnosis mainly depends on imaging modalities. The aim of this study was to investigate the ability of color Doppler ultrasound (CDU) in the diagnosis and assessment of CBT based on computed tomography (CT). We retrospectively reviewed the CDU and CT features of 49 consecutive CBTs and 23 schwannomas from 67 patients and compared these findings with surgical resection specimens. The mean size of CBT lesions on ultrasound scans and CT angiography (CTA) was 3.24 cm ± 0.82 cm (range, 1.6-5.2 cm) and 3.84 cm ± 1.08 cm (range, 1.8-6.8 cm), respectively, which had statistically significant difference (t = 9.815, p = 0.000). The vascularity of CBT lesions was richer than that of schwannoma lesions (p < 0.05). Intra-lesional vascularities feeding CBT mostly arose from the external carotid artery and had spectrum characteristics including low velocity and resistance. Peak systolic velocity (PSV) and resistance index (RI) of the vasa vasorum were 39.8 cm/s ± 19.8 cm/s and 0.54 ± 0.06, respectively. There was the correlation between CTA and CDU in identifying Shamblin type I CBT lesions, while CTA technique was superior for CDU, identifying Shamblin type II and III CBT lesions. Accuracy, specificity and sensitivity of CDU in diagnosing CBTs were 87.5% (63 of 72), 82.6% (19 of 23) and 89.8% (44 of 49), respectively. Both accuracy and sensitivity of CTA in diagnosing CBTs were 100%. CDU can be useful for assessment of Shamblin's type and intra-lesional blood flow of CBTs before its metastases, while CT imaging can reveal the relationship between lesions and adjacent arteries, as well as the involvement of the skull base. CDU combined with CT imaging can be used as an optimal detection modality for the assessment and management of CBT.

  16. Color Doppler ultrasound criteria to diagnose varicoceles: correlation of a new scoring system with physical examination.

    PubMed

    Chiou, R K; Anderson, J C; Wobig, R K; Rosinsky, D E; Matamoros, A; Chen, W S; Taylor, R J

    1997-12-01

    Color Doppler ultrasound (CDU) diagnostic criteria for varicoceles are poorly defined, and the role of CDU in diagnosing varicoceles is controversial. The purpose of this study is to assess the diagnostic accuracy of CDU for varicoceles compared to physical examination. We prospectively studied 64 patients with CDU and collected the following data: maximum diameter of scrotal veins, the presence of a venous plexus, sum of the diameter of up to six veins of the plexus, and the duration and amplitude of flow change on Valsalva maneuver. To avoid interphysician variation, all patients were examined by one designated senior urologist with the sonographer remaining unaware of the findings. CDU parameters of 127 testis units in 64 patients were analyzed and compared to the physical findings. Fifty-nine testis units were positive and 57 units were negative for varicocele on physical examination. In 11 testis units, results of physical examination were inconclusive regarding the presence of varicocele. The commonly accepted CDU criterion for varicocele (maximal vein diameter of 3 mm or greater) had a sensitivity of 53% and specificity of 91% compared to physical examination. We developed a new scoring system incorporating the maximal venous diameter (score 0 to 3), the presence of a venous plexus and the sum of the diameters of veins in the plexus (score 0 to 3), and the change of flow on Valsalva maneuver (score 0 to 3). Using a total score of 4 or more to define the presence of CDU-positive varicocele, we observed a sensitivity of 93% and a specificity of 85% when compared to physical examination. All moderate to large varicoceles found on physical examination were positive by CDU diagnosis using the scoring system, but the same group had only a 68% positive rate by traditional CDU diagnostic criteria. Using the proposed new scoring system, CDU has been shown to be a reliable and accurate method of diagnosis for varicoceles compared to the current reference standard

  17. The application of color Doppler flow imaging in the diagnosis and therapeutic effect evaluation of erectile dysfunction.

    PubMed

    Xuan, Xu-Jun; Bai, Gang; Zhang, Cai-Xia; Xu, Chao; Lu, Fu-Ding; Peng, Yang; Ma, Gang; Han, Cong-Hui; Chen, Jun

    2016-01-01

    We aim to investigate the correlations between hemodynamic parameters, penile rigidity grading, and the therapeutic effects of phosphodiesterase type 5 inhibitors using color Doppler flow imaging after intracavernosal injection in patients with erectile dysfunction. This study involved 164 patients. After intracavernosal injection with a mixture of papaverine (60 mg), prostaglandin E 1 (10 mg), and lidocaine (2%, 0.5-1 ml), the penile vessels were assessed using color Doppler flow imaging. Penile rigidity was classified based on the Erection Hardness Score system as Grades 4, 3, 2 or 1 (corresponding to Schramek Grades V to II). Then, the patients were given oral sildenafil (50-100 mg) and scored according to the International Index of Erectile Function (IIEF-5) questionnaire. The number of patients with penile rigidities of Schramek Grades II to V was 14, 18, 21, and 111, respectively. The IIEF-5 score was positively correlated with the refilling index of the penile cavernosal artery (r = 0.79, P< 0.05), the peak systolic velocity (r = 0.45, P< 0.05), and penile rigidity (r = 0.75, P< 0.05), and was negatively correlated with the end diastolic velocity (r = -0.74, P< 0.05). For patients with erectile dysfunction, both the IIEF-5 score after sildenafil administration, which is correlated with penile rigidity, and the hemodynamic parameters detected using color Doppler flow imaging may predict the effects of phosphodiesterase type 5 inhibitor treatment and could provide a reasonable model for the targeted-treatment of erectile dysfunction.

  18. Impact of contrast-enhanced ultrasound in patients with renal function impairment

    PubMed Central

    Girometti, Rossano; Stocca, Tiziano; Serena, Elena; Granata, Antonio; Bertolotto, Michele

    2017-01-01

    AIM To investigate the role of contrast enhanced ultrasound (CEUS) in evaluating patients with renal function impairment (RFI) showing: (1) acute renal failure (ARF) of suspicious vascular origin; or (2) suspicious renal lesions. METHODS We retrospectively evaluated patients addressed to CEUS over an eight years period to rule-out vascular causes of ARF (first group of 50 subjects) or assess previously found suspicious renal lesions (second group of 41 subjects with acute or chronic RFI). After preliminary grey-scale and color Doppler investigation, each kidney was investigated individually with CEUS, using 1.2-2.4 mL of a sulfur hexafluoride-filled microbubble contrast agent. Image analysis was performed in consensus by two readers who reviewed digital clips of CEUS. We calculated the detection rate of vascular abnormalities in the first group and performed descriptive statistics of imaging findings for the second group. RESULTS In the first group, CEUS detected renal infarction or cortical ischemia in 18/50 patients (36%; 95%CI: 23.3-50.9) and 1/50 patients (2%; 95%CI: 0.1-12), respectively. The detection rate of infarction was significantly higher (P = 0.0002; McNemar test) compared to color Doppler ultrasonography (10%). No vascular causes of ARF were identified in the remaining 31/50 patients (62%). In the second group, CEUS detected 41 lesions on 39 patients, allowing differentiation between solid lesions (21/41; 51.2%) vs complex cysts (20/41; 48.8%), and properly addressing 15/39 patients to intervention when feasible based on clinical conditions (surgery and cryoablation in 13 and 2 cases, respectively). Cysts were categorized Bosniak II, IIF, III and IV in 8, 5, 4 and 3 cases, respectively. In the remaining two patients, CEUS found 1 pseudolesion and 1 subcapsular hematoma. CONCLUSION CEUS showed high detection rate of renal perfusion abnormalities in patients with ARF, influencing the management of patients with acute or chronic RFI and renal masses

  19. Differential effect of 3-dimensional color Doppler echocardiography for the quantification of mitral regurgitation according to the severity and characteristics.

    PubMed

    Choi, Jaehuk; Heo, Ran; Hong, Geu-Ru; Chang, Hyuk-Jae; Sung, Ji Min; Shin, Sang Hoon; Cho, In Jeong; Shim, Chi-Young; Chung, Namsik

    2014-05-01

    The aim of this study is to explore the differential effect of 3-dimensional color Doppler echocardiography for the quantification of mitral regurgitation (MR). Two-dimensional color Doppler echocardiography-based MR quantification has well-documented limitations. We consecutively enrolled 221 patients with MR. Adequate image quality was obtained by 2D- and 3D-color Doppler echocardiography in 211 (95.5%) patients. The quantitative differences between the MR volumes obtained by 2D- and 3D-proximal isovelocity surface area (PISA) were analyzed in various MR subgroups. In the validation cohort (n=52), MR volume obtained by 3D-PISA showed a better agreement with phase-contrast cardiac MRI than 2D-PISA (r=0.97 versus 0.84). In all 211 patients, 2D-PISA underestimated the MR volume when compared with 3D-PISA (52.4±19.6 versus 59.5±25.6 mL; P=0.005). A total of 33.3% with severe MR based on 3D-PISA were incorrectly assessed by 2D-PISA as having nonsevere MR. In the subgroup analysis, the MR severity (odds ratio, 6.96; 95% confidence interval, 3.04-15.94; P<0.001) and having an asymmetrical orifice (odds ratio, 11.48; 95% confidence interval, 3.72-35.4; P<0.001), and an eccentric jet (odds ratio, 3.82; 95% confidence interval, 1.27-11.48; P=0.017) were predictors of significant difference in MR volume (>15 mL) between 2D- and 3D-PISA methods. Quantification of MR by 3D-PISA method is clinically feasible and more accurate than the current 2D-PISA method. MR quantification by 2D-PISA significantly underestimated MR volume with severe, eccentric MR with an asymmetrical orifice. This article demonstrates that 3D-color Doppler echocardiography could be used as a valuable tool to confirm treatment strategy in patients with significant MR. © 2014 American Heart Association, Inc.

  20. Device sizing for transcatheter closure of ruptured sinus of Valsalva as per echocardiography color Doppler turbulent flow jet diameter.

    PubMed

    Ahmed, Khurshid; Munawar, Muhammad; Chakraborty, Rabin; Hartono, Beny; Yusri, Achmad

    2015-01-01

    Rupture of sinus of Valsalva (SV) is a rare occurrence with a wide spectrum of presentation, ranging from an asymptomatic murmur to cardiogenic shock or even sudden cardiac death. We hereby report a case which was successfully closed by transcatheter technique. In this case, ruptured SV was entered from the aorta, an arteriovenous loop was created and device was implanted using a venous approach. The procedure was safe, effective and uncomplicated, obviating the need for surgery. In this case, the authors report for the first time the use of echo color Doppler turbulent flow jet diameter as a reference value for sizing the device.

  1. Spatio-temporal mapping of intracardiac pressure gradients. A solution to Euler's equation from digital postprocessing of color Doppler M-mode echocardiograms.

    PubMed

    Bermejo, J; Antoranz, J C; Yotti, R; Moreno, M; García-Fernández, M A

    2001-05-01

    Doppler assessment of intracardiac pressure gradients using the simplified Bernoulli equation is inaccurate in the absence of a restricted orifice. The purpose of this study is to develop a new general method to map instantaneous pressure gradients inside the heart using Doppler echocardiography. Color Doppler M-mode recordings are digitally postprocessed with a software algorithm that decodes flow velocity and fits a bivariate spatio-temporal tensor-product smoothing spline. Temporal and spatial accelerations are then calculated by analytical derivation of the fitted velocity data, allowing solution of both inertial and convective terms of Euler's equation. A database of 39 transmitral inflow and transaortic outflow color Doppler M-mode recordings from 20 patients with a number of cardiac conditions was analysed, along with matched pulsed-wave spectral recordings. A close agreement was observed between the spectral and postprocessed color Doppler velocity values (error = 0.8 +/- 11.7 cm/s), validating the data decoding and fitting process. Spatio-temporal pressure-gradient maps were obtained from all studies, allowing visualisation of instantaneous pressure gradients from the atrium to the apex during left ventricular filling, and from the apex to the outflow tract during ejection. Instantaneous pressure differences between localised intracardiac sample points closely matched previously published catheterization findings, both in magnitude and waveform shape. Our method shows that intracardiac instantaneous pressure gradients can be analysed noninvasively using color Doppler M-mode echocardiography combined with image postprocessing methods.

  2. Contrast-enhanced and targeted ultrasound

    PubMed Central

    Postema, Michiel; Gilja, Odd Helge

    2011-01-01

    Ultrasonic imaging is becoming the most popular medical imaging modality, owing to the low price per examination and its safety. However, blood is a poor scatterer of ultrasound waves at clinical diagnostic transmit frequencies. For perfusion imaging, markers have been designed to enhance the contrast in B-mode imaging. These so-called ultrasound contrast agents consist of microscopically small gas bubbles encapsulated in biodegradable shells. In this review, the physical principles of ultrasound contrast agent microbubble behavior and their adjustment for drug delivery including sonoporation are described. Furthermore, an outline of clinical imaging applications of contrast-enhanced ultrasound is given. It is a challenging task to quantify and predict which bubble phenomenon occurs under which acoustic condition, and how these phenomena may be utilized in ultrasonic imaging. Aided by high-speed photography, our improved understanding of encapsulated microbubble behavior will lead to more sophisticated detection and delivery techniques. More sophisticated methods use quantitative approaches to measure the amount and the time course of bolus or reperfusion curves, and have shown great promise in revealing effective tumor responses to anti-angiogenic drugs in humans before tumor shrinkage occurs. These are beginning to be accepted into clinical practice. In the long term, targeted microbubbles for molecular imaging and eventually for directed anti-tumor therapy are expected to be tested. PMID:21218081

  3. Contrast-enhanced and targeted ultrasound.

    PubMed

    Postema, Michiel; Gilja, Odd Helge

    2011-01-07

    Ultrasonic imaging is becoming the most popular medical imaging modality, owing to the low price per examination and its safety. However, blood is a poor scatterer of ultrasound waves at clinical diagnostic transmit frequencies. For perfusion imaging, markers have been designed to enhance the contrast in B-mode imaging. These so-called ultrasound contrast agents consist of microscopically small gas bubbles encapsulated in biodegradable shells. In this review, the physical principles of ultrasound contrast agent microbubble behavior and their adjustment for drug delivery including sonoporation are described. Furthermore, an outline of clinical imaging applications of contrast-enhanced ultrasound is given. It is a challenging task to quantify and predict which bubble phenomenon occurs under which acoustic condition, and how these phenomena may be utilized in ultrasonic imaging. Aided by high-speed photography, our improved understanding of encapsulated microbubble behavior will lead to more sophisticated detection and delivery techniques. More sophisticated methods use quantitative approaches to measure the amount and the time course of bolus or reperfusion curves, and have shown great promise in revealing effective tumor responses to anti-angiogenic drugs in humans before tumor shrinkage occurs. These are beginning to be accepted into clinical practice. In the long term, targeted microbubbles for molecular imaging and eventually for directed anti-tumor therapy are expected to be tested.

  4. Three-dimensional color Doppler transesophageal echocardiography for mitral paravalvular leak quantification and evaluation of percutaneous closure success.

    PubMed

    Franco, Eduardo; Almería, Carlos; de Agustín, Jose Alberto; Arreo Del Val, Viviana; Gómez de Diego, José Juan; García Fernández, Miguel Ángel; Macaya, Carlos; Pérez de Isla, Leopoldo; Garcia, Eulogio

    2014-11-01

    Three-dimensional (3D) color Doppler transesophageal echocardiography (TEE) enables accurate planimetry of the effective regurgitant orifice (ERO) of a mitral paravalvular leak (PVL). The aim of this study was to evaluate the usefulness of this method to quantify paravalvular regurgitation and to assess percutaneous PVL closure success, compared with 3D planimetry of PVLs without using color-flow images (3D anatomic regurgitant orifice [ARO]). Forty-six patients (59 mitral PVLs) who underwent 3D TEE to evaluate the indication of PVL closure procedure were retrospectively included. Receiver operating characteristic curves were compared to identify degree III and IV paravalvular regurgitation of 3D color ERO and 3D ARO measures. Forty patients underwent percutaneous PVL closure procedures; analysis was conducted to determine whether the undersizing of the closure devices according to 3D color ERO and 3D ARO measures was associated with PVL closure failure. Three-dimensional ERO measures showed better areas under the curve than 3D ARO measures and correlated better with the degree of paravalvular regurgitation. Three-dimensional color ERO major diameter ≥ 0.65 cm showed a positive predictive value of 87.1% and a negative predictive value of 94% to diagnose degree III and IV paravalvular regurgitation. For the 40 patients who underwent PVL closure procedures, the immediate technical success rate was 76.9%, and 1-year estimated survival was 69.5%. Closure device undersizing according to 3D color ERO length, but not other PVL measurements, was significantly associated with PVL closure failure (P = .007). Three-dimensional ERO was superior to 3D ARO at identifying the presence of degree III and IV paravalvular regurgitation. The undersizing of closure devices according to 3D color ERO length was associated with failed closure procedures. Confirmatory prospective studies are encouraged. Copyright © 2014 American Society of Echocardiography. Published by Elsevier Inc

  5. [Color-coded M-mode Doppler echocardiography in the diagnosis of fetal arrhythmia].

    PubMed

    Gembruch, U; Bald, R; Hansmann, M

    1990-04-01

    Colour-coded M-mode Doppler echocardiography is a simultaneous registration of the conventional M-mode echocardiogram and of the pulsed wave colour-coded Doppler echocardiogram with simultaneous analysis of several sample volumes along the ultrasound cursor with a high timely resolution, guided by the two-dimensional imaging. Within 9 months, 36 foetuses with arrhythmias were prospectively examined (24 foetuses with atrial premature beats, 9 foetuses with supraventricular tachycardia, and 3 foetuses with complete heart block). The classification of arrhythmia by the colour-coded M-mode Doppler echocardiography was always possible at first examination. The most important advantage of this method is the simultaneous registration of the information of conventional M-mode and Doppler echocardiography. Therefore, the intervals between atrial and ventricular contractions can also be analysed even when the angle of insonation to the foetal heart is unfavourable, since contractions cannot only be identified by wall movements but also by the flow velocities. Furthermore, the duration of regurgitation of atrioventricular valves can be exactly measured by colour-coded M-mode Doppler echocardiography. In foetal supraventricular tachycardia, it appears that severity of congestive heart failure is correlated with the duration of atrioventricular valve regurgitation up to a holosystolic insufficiency. Thus, it seems possible, that the duration of insufficiency of atrioventricular valves is a good parameter for evaluation of cardiac function and for modifying antiarrhythmic treatment in cases of supraventricular tachycardia.

  6. Support vector analysis of color-Doppler images: a new approach for estimating indices of left ventricular function.

    PubMed

    Rojo-Alvarez, J L; Bermejo, J; Juárez-Caballero, V M; Yotti, R; Cortina, C; García-Fernández, M A; Antoranz, J C

    2006-08-01

    Reliable noninvasive estimators of global left ventricular (LV) chamber function remain unavailable. We have previously demonstrated a potential relationship between color-Doppler M-mode (CDMM) images and two basic indices of LV function: peak-systolic elastance (Emax) and the time-constant of LV relaxation (tau). Thus, we hypothesized that these two indices could be estimated noninvasively by adequate postprocessing of CDMM recordings. A semiparametric regression (SR) version of support vector machine (SVM) is here proposed for building a blind model, capable of analyzing CDMM images automatically, as well as complementary clinical information. Simultaneous invasive and Doppler tracings were obtained in nine mini-pigs in a high-fidelity experimental setup. The model was developed using a test and validation leave-one-out design. Reasonably acceptable prediction accuracy was obtained for both Emax (intraclass correlation coefficient Ric, = 0.81) and tau (Ric, = 0.61). For the first time, a quantitative, noninvasive estimation of cardiovascular indices is addressed by processing Doppler-echocardiography recordings using a learning-from-samples method.

  7. Evaluation of descending aortic flow volumes and effective orifice area through aortic coarctation by spatiotemporal integration of color Doppler data: An in vitro study.

    PubMed

    Wanitkun, S; Gharib, M; Zarandi, M; Shiota, T; Sahn, D J

    1999-06-01

    Flow volumes in an in vitro model of the aorta with 3 different degrees of stiffness (stiff, moderately stiff, and compliant) proximal to a coarctation were calculated by using a digital color Doppler echocardiography flow calculation method that semiautomatically integrates spatial and temporal color flow velocity data. These flow volumes were compared with those obtained by the conventional pulsed Doppler method with reference to ultrasonic flowmeter. Flow volumes determined by the automated method agreed well with those obtained by ultrasonic flowmeter, even in this compliant aorta model with vessel size changing with pulsation, whereas the pulsed Doppler method overestimated the reference data, especially for more compliant descending aortic segments. The combination of flow data with continuous wave Doppler allows definition of effective orifice area for coarctation.

  8. Triple-energy contrast enhanced digital mammography

    NASA Astrophysics Data System (ADS)

    Puong, Sylvie; Milioni de Carvalho, Pablo; Muller, Serge

    2010-04-01

    With the injection of iodine, Contrast Enhanced Digital Mammography (CEDM) provides functional information about breast tumour angiogenesis that can potentially help in cancer diagnosis. In order to generate iodine images in which the gray level is proportional to the iodine thickness, temporal and dual-energy approaches have already been considered. The dual-energy method offers the advantage of less patient motion artifacts and better comfort during the exam. However, this approach requires knowledge of the breast thickness at each pixel. Generally, as compression is applied, the breast thickness at each pixel is taken as the compression thickness. Nevertheless, in the breast border region, this assumption is not correct anymore and this causes inaccuracies in the iodine image. Triple-Energy CEDM could overcome these limitations by providing supplemental information in the form of a third image acquired with a different spectrum than the other two. This precludes the need of a priori knowledge of the breast thickness. Moreover, with Triple-Energy CEDM, breast thickness and glandularity maps could potentially be derived. In this study, we first focused on the method to recombine the three images in order to generate the iodine image, analyzing the performance of either quadratic, cubic or conic recombination functions. Then, we studied the optimal acquisition spectra in order to maximize the iodine SDNR in the recombined image for a given target total glandular dose. The concept of Triple-Energy CEDM was validated on simulated textured images and poly-energetic images acquired with a conventional X-ray mammography tube.

  9. [Vascular architectonics of eye and orbital space in color reflection of doppler spectrum energy].

    PubMed

    Kharlap, S I

    1999-01-01

    Super-sharp gray scale image and highly sensitive digital wide-band Doppler, three-dimensional visualization of vessels in the pulsed energy Doppler mode were used in examination of the posterior segment of the eye, optic nerve, and orbital space. Twelve healthy volunteers (24 eyes) aged 25-45 years were examined. The architectonics of the optic disk and the blood filling of the arterial Zinn-Haller circle, reticular platelet, choroid, posterior long and posterior short ciliary arteries were studied. Vascular architectonics of the retrobulbar space was studied by the three-dimensional reconstruction in the energy Doppler mode and the borders of the vascular plexus round the optic nerve were defined.

  10. An evaluation of B-mode and color Doppler ultrasonography for detecting periovulatory events in the bitch.

    PubMed

    Bergeron, Lindsay H; Nykamp, Stephanie G; Brisson, Brigitte A; Madan, Pavneesh; Gartley, Cathy J

    2013-01-15

    When determining optimal breeding time in the bitch, specific periovulatory events must be identified. The main objectives were to relate ultrasonographic changes in ovarian blood flow, follicle/corpora lutea count and echotexture to periovulatory events, and to assess the efficacy of each for identifying these events. Twelve Beagle (N = 3), Beagle-cross (N = 2) and hound-cross (N = 7) bitches (body weight range, 7.5-27.5 kg) were examined daily from the onset of proestrus to approximately 4 days post-LH peak. Follicle and corpora lutea count and echotexture analyses were performed using B-mode ultrasound and ovarian blood flow analysis was performed using color Doppler ultrasound. Serum LH concentrations were analyzed by validated RIA. There was an increase (P < 0.05) in ovarian blood flow from the day of the preovulatory LH peak (605 pixels; confidence interval, 397-856), to 1 day after this peak (1092 pixels; confidence interval, 724-1535), enabling detection of the preovulatory LH peak. There were no significant changes in follicle/corpora lutea echotexture relative to days from the preovulatory LH peak. There were significant decreases in follicle/corpora lutea number between Days -1 and 3; Days -1 and 4; and Days 0 and 3, relative to the preovulatory LH peak. We concluded that color Doppler ultrasound performed once daily was more accurate in identifying the preovulatory LH peak than B-mode ultrasound and enabled prospective determination of ovulation.

  11. The use of non-contrast computed tomography and color Doppler ultrasound in the characterization of urinary stones - preliminary results

    PubMed Central

    Bulakçı, Mesut; Tefik, Tzevat; Akbulut, Fatih; Örmeci, Mehmet Tolgahan; Beşe, Caner; Şanlı, Öner; Oktar, Tayfun; Salmaslıoğlu, Artür

    2015-01-01

    Objective To investigate the role of density value in computed tomography (CT) and twinkling artifact observed in color Doppler analysis for the prediction of the mineral composition of urinary stones. Material and methods A total of 42 patients who were operated via percutaneous or endoscopic means and had undergone abdominal non-contrast CT and color Doppler ultrasonography examinations were included in the study. X-ray diffraction method was utilized to analyze a total of 86 stones, and the correlations between calculated density values and twinkling intensities with stone types were investigated for each stone. Results Analyses of extracted stones revealed the presence of 40 calcium oxalate monohydrate, 12 calcium oxalate dihydrate, 9 uric acid, 11 calcium phosphate, and 14 cystine stones. The density values were calculated as 1499±269 Hounsfield Units (HU) for calcium oxalate monohydrate, 1505±221 HU for calcium oxalate dihydrate, 348±67 HU for uric acid, 1106±219 HU for calcium phosphate, and 563±115 HU for cystine stones. The artifact intensities were determined as grade 0 in 15, grade 1 in 32, grade 2 in 24, and grade 3 in 15 stones. Conclusion In case the density value of the stone is measured below 780 HU and grade 3 artifact intensity is determined, it can be inferred that the mineral composition of the stone tends to be cystine. PMID:26623143

  12. Proximal isovelocity surface area by single-beat three-dimensional color Doppler echocardiography applied for tricuspid regurgitation quantification.

    PubMed

    de Agustin, Jose Alberto; Viliani, Dafne; Vieira, Catarina; Islas, Fabian; Marcos-Alberca, Pedro; Gomez de Diego, Jose Juan; Nuñez-Gil, Ivan Javier; Almeria, Carlos; Rodrigo, Jose Luis; Luaces, Maria; Garcia-Fernandez, Miguel Angel; Macaya, Carlos; Perez de Isla, Leopoldo

    2013-09-01

    The two-dimensional (2D) proximal isovelocity surface area (PISA) method has known technical limitations, mainly the geometric assumptions of PISA shape required to calculate effective regurgitant orifice area (EROA). Recently developed single-beat real-time three-dimensional (3D) color Doppler imaging allows the direct measurement of PISA without geometric assumptions and has already been validated for mitral regurgitation assessment. The aim of this study was to apply this novel method in patients with chronic tricuspid regurgitation (TR). Ninety patients with chronic TR were enrolled. EROA and regurgitant volume (Rvol) were assessed using transthoracic 2D and 3D PISA methods. Quantitative Doppler and 3D transthoracic planimetry of EROA were used as reference methods. Both EROA and Rvol assessed using the 3D PISA method had better correlations with the reference methods than using conventional 2D PISA, particularly in the assessment of eccentric jets. On the basis of 3D planimetry-derived EROA, 35 patients had severe TR (EROA ≥ 0.4 cm(2)). Among these 35 patients, 25.7% (n = 9) were underestimated as having nonsevere TR (EROA ≤ 0.4 cm(2)) using the 2D PISA method. In contrast, the 3D PISA method had 94.3% agreement (33 of 35) with 3D planimetry in classifying severe TR. Good intraobserver and interobserver agreement for 3D PISA measurements was observed, with intraclass correlation coefficients of 0.92 and 0.88 respectively. TR quantification using PISA by single-beat real-time 3D color Doppler echocardiography is feasible in the clinical setting and more accurate than the conventional 2D PISA method. Copyright © 2013 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

  13. New method of dynamic color doppler signal quantification in metastatic lymph nodes compared to direct polarographic measurements of tissue oxygenation.

    PubMed

    Scholbach, Thomas; Scholbach, Jakob; Krombach, Gabriele A; Gagel, Bernd; Maneschi, Payam; Di Martino, Ercole

    2005-05-10

    Tumor growth depends on sufficient blood and oxygen supply. Hypoxia stimulates neovascularization and is a known cause for radio- and chemoresistance. The objective of this study was to investigate the use of a novel ultrasound technique for the dynamic assessment of vascularization and oxygenation in metastatic lymph nodes. Twenty-four patients (age 44-78 years) with cervical lymph node metastases of squamous cell head and neck cancer were investigated by color duplex sonography and 17 (age 46-78 years) were investigated additionally with polarography. Sonography was performed after contrast enhancer infusion under defined conditions. Intranodal perfusion data (color hue, colored area) were measured automatically by a novel software technique. This allows an evaluation of blood flow dynamics by calculating perfusion intensity--velocity, perfused area, as well as the novel parameters tissue resistance index (TRI) and tissue pulsatility index (TPI)--for each point of a complete heart cycle. Tumor tissue pO(2) was measured by means of polarographic needle electrodes placed intranodally. The sonographic and polarographic data were correlated using Pearson's test. Sonography demonstrated a statistically significant inverse correlation between hypoxia and perfusion and significant TPI and TRI changes with different N-stages. The percentage of nodal fraction with less than 10 mmHg oxygen saturation was significantly inversely correlated with lymph node perfusion (r = -0.551; p = 0.021). Nodes with a perfusion of less than 0.05 cm/sec flow velocity showed significantly larger hypoxic areas (p = 0.006). Significant differences of TPI and TRI existed between nodes in stage N(1) and N(2)/N(3) (p = 0.028 and 0.048, respectively). This new method of dynamic signal quantification allows a noninvasive and quantitative assessment of tumor and metastatic lymph node perfusion by means of commonly available ultrasound equipment.

  14. Is color-Doppler US a reliable method in the follow-up of transjugular intrahepatic portosystemic shunt (TIPS)?

    PubMed Central

    Ricci, P.; Cantisani, V.; Lombardi, V.; Alfano, G.; D'Ambrosio, U.; Menichini, G.; Marotta, E.; Drudi, F.M.

    2007-01-01

    Transjugular intrahepatic portosystemic shunt (TIPS) has become a widely accepted treatment for complications of portal hypertension. Shunt or hepatic vein stenoses or occlusions are common short- and mid-term complications of the procedure, with a one-year primary patency ranging from 25% to 66%. When promptly identified, shunt stenosis or occlusion may be treated before the recurrence of gastrointestinal bleeding or ascites. The revision is usually successful and the primary-assisted patency of TIPS is approximately 85% at one year. Doppler sonography is a widely accepted screening modality for TIPS patients, both as a routine follow-up in asymptomatic patients and in those cases with clinically suspected TIPS malfunction. In a routine US follow-up, a TIPS patient is scheduled for a control 24 h after the procedure, and then after one week, 1 month, 3 months, and at 3-month intervals thereafter. Venography is at present performed solely on the basis of a suspected shunt dysfunction during the sonographic examination. Color-Doppler sonography is the most reliable method for monitoring the shunt function after TIPS implantation. Several studies have shown that Doppler sonography is a sensitive and relatively specific way to detect shunt malfunction, particularly when multiple parameters are examined. Achieving high sensitivity is optimal so that malfunctioning shunts can be identified and shunt revision can be performed before symptomatic deterioration. Venous angiography is at present indicated only on the basis of US suspicion of shunt compromise. Power-Doppler US and US contrast media can be useful in particular conditions, but are not really fundamental. PMID:23396711

  15. Gray-scale and color Doppler ultrasound imaging findings of an ovarian inguinal hernia and torsion of the herniated ovary: a case report.

    PubMed

    Aydin, Ramazan; Polat, Ahmet Veysel; Ozaydin, Ilkay; Aydin, Gulten

    2013-03-01

    Inguinal hernia is extremely rare among girls. The hernia sac may sometimes involve intestinal structures, but ovaries in the sac are uncommon. Early diagnosis of a possible ovarian torsion is essential because potential amenable benefits can be achieved with surgery. A baby girl was admitted to our pediatric emergency unit with the complaints of swelling and erythema of the left groin. Then gray-scale ultrasonography and color Doppler ultrasonography was performed immediately at the emergency radiology room. In our case, ovarian torsion was diagnosed by gray-scale ultrasonography and color Doppler ultrasonography. After the diagnosis of ovarian torsion, the patient underwent surgery. It is possible to diagnose inguinal emergencies by high-resolution ultrasonography and color Doppler ultrasonography.

  16. The Diagnostic Value of Transvaginal Sonograph (TVS), Color Doppler, and Serum Tumor Marker CA125, CEA, and AFP in Ovarian Cancer.

    PubMed

    Zhang, Fang; Zhang, Zhou-Long

    2015-06-01

    The purpose of this study is to investigate the diagnostic value of transvaginal sonograph (TVS), color Doppler, and serum tumor marker CA125, CEA, and AFP in ovarian cancer. From June, 2011 to May, 2013, 102 cases with adnexal mass were recruited in this study (32 cases of malignant ovarian cancer and 70 cases of benign ovarian tumor according to pathological diagnosis). TVS, color Doppler, and serum tumor markers were used for tumor diagnosis. The sensitivity, specifity, positive prediction, negative prediction, and Youden's index were analyzed. Of the 102 patients, 32 were diagnosed with malignant ovarian cancer and 70 were diagnosed with benign ovarian tumor according to pathological diagnosis. Based on TVS results, 37 cases were malignant while 65 cases were benign. Based on color Doppler results, 34 cases were malignant while 68 cases were benign. Based on TVS and color Doppler results, 35 cases were malignant while 65 were benign. Based on CA125 test results, 34 cases were malignant while 68 cases were benign. Based on CEA test results, 8 cases were malignant and 94 cases were benign. Bases on AFP test results, 9 cases were malignant while 93 cases were benign. Based on the results of combination tumor marker test, 38 cases were malignant while 64 cases were benign. The combination of TVS, color Doppler, and tumor marker test showed optimal diagnostic value with a sensitivity of 90.63 %, specificity of 97.14 %, positive prediction of 93.94 %, negative prediction of 98.55 %, and Youden's index of 94.02 %. The combination of TVS, color Doppler, and tumor marker test is of great diagnostic value, which should be widely used in clinical practice.

  17. Color Doppler analysis of female reproductive vasculature in Behçet's disease.

    PubMed

    Tezcan, M E; Temizkan, O; Ozderya, A; Melikoglu, M; Aydin, K; Sargin, M; Temizkan, S

    2015-12-30

    Behçet's disease (BD) may affect female reproductive vasculature. We aimed to evaluate Doppler sonographic characteristics of female reproductive vasculature and also ovarian volume, endometrial thickness (EMT) and antral follicle count of BD patients in comparison with a healthy control group. Seventeen premenopausal women aged between 18-45 years with BD, and a control group of 31 age- and body mass index-matched healthy women was included in the study. Uterine, spiral and intraovarian artery blood flow were examined by Doppler sonography in the late follicular phase. Resistance index, pulsatility index and systolic/diastolic ratio were recorded together with ovarian volume, EMT and antral follicle count. In particular this is a pilot study including the evaluation of the spiral and uterine arteries in BD. Doppler sonographic parameters, ovarian volume, EMT and antral follicle count of BD patients and healthy controls were not found to be statistically different. As a result of our analysis, we found similar Doppler sonographic features of both BD patients and the control group. Further studies conducted on a larger sample population with more aggressive BD symptoms may reveal the actual effect of BD on the female reproductive system.

  18. Comparison of fetal middle cerebral arteries, umbilical and uterin artery color Doppler ultrasound with blood gas analysis in pregnancy complicated by IUGR.

    PubMed

    Fardiazar, Zahra; Atashkhouei, Simin; Yosefzad, Yousef; Goldust, Mohamad; Torab, Reza

    2013-01-01

    Fetal color Doppler is important for evaluation of hypoxia in intrauterine growth restriction (IUGR) fetus. In this study we compare fetal and maternal color Doppler with blood gas analysis to detect fetal acidosis. In this cross-sectional study we evaluated 100 hospitalized patients with IUGR for comparison of color Doppler results with arterial blood gas analysis. RESULTS of Doppler sonography of fetus middle cerebral arteries, umbilical and uterine artery and umbilical artery ABG were studied in these neonates. Mean maternal age was 28±7 years, mean gestational age was 31.79±2.59 weeks and mean growth restriction was 3±2 weeks. Resistance increasing was observed in right uterine arteries of 37 mothers. It was normal in 60 mothers. Resistance increasing was observed in left uterine arteries of 36 mothers and nuch was seen in four cases. PCO2, PO2, and pH mean were 48.41±9.50 mmHg, 26.00±12.34 mmHg, and 7.28±0.10 in the neonates respectively. In this study abnormal color Doppler in IUGR fetuses have no significant correlation with umbilical cord blood gas.

  19. Comparison of fetal middle cerebral arteries, umbilical and uterin artery color Doppler ultrasound with blood gas analysis in pregnancy complicated by IUGR

    PubMed Central

    Fardiazar, Zahra; Atashkhouei, Simin; Yosefzad, Yousef; Goldust, Mohamad; Torab, Reza

    2013-01-01

    Background: Fetal color Doppler is important for evaluation of hypoxia in intrauterine growth restriction (IUGR) fetus. Objective: In this study we compare fetal and maternal color Doppler with blood gas analysis to detect fetal acidosis. Materials and Methods: In this cross-sectional study we evaluated 100 hospitalized patients with IUGR for comparison of color Doppler results with arterial blood gas analysis. Results of Doppler sonography of fetus middle cerebral arteries, umbilical and uterine artery and umbilical artery ABG were studied in these neonates. Results: Mean maternal age was 28±7 years, mean gestational age was 31.79±2.59 weeks and mean growth restriction was 3±2 weeks. Resistance increasing was observed in right uterine arteries of 37 mothers. It was normal in 60 mothers. Resistance increasing was observed in left uterine arteries of 36 mothers and nuch was seen in four cases. PCO2, PO2, and pH mean were 48.41±9.50 mmHg, 26.00±12.34 mmHg, and 7.28±0.10 in the neonates respectively. Conclusion: In this study abnormal color Doppler in IUGR fetuses have no significant correlation with umbilical cord blood gas. PMID:24639692

  20. Effect of scanline orientation on ventricular flow propagation: assessment using high frame-rate color Doppler echocardiography

    NASA Technical Reports Server (NTRS)

    Greenberg, N. L.; Castro, P. L.; Drinko, J.; Garcia, M. J.; Thomas, J. D.

    2000-01-01

    Color M-mode echocardiography has recently been utilized to describe diastolic flow propagation velocity (Vp) in the left ventricle. While increasing temporal resolution from 15 to 200 Hz, this M-mode technique requires the user to select a single scanline, potentially limiting quantification of Vp due to the complex three-dimensional inflow pattern. We previously performed computational fluid dynamics simulations to demonstrate the insignificance of the scanline orientation, however geometric complexity was limited. The purpose of this study was to utilize high frame-rate 2D color Doppler images to investigate the importance of scanline selection in patients for the quantification of Vp. 2D color Doppler images were digitally acquired at 50 frames/s in 6 subjects from the apical 4-chamber window (System 5, GE/Vingmed, Milwaukee, WI). Vp was determined for a set of scanlines positioned through 5 locations across the mitral annulus (from the anterior to posterior mitral annulus). An analysis of variance was performed to examine the differences in Vp as a function of scanline position. Vp was not effected by scanline position in sampled locations from the center of the mitral valve towards the posterior annulus. Although not statistically significant, there was a trend to slower propagation velocities on the anterior side of the valve (60.8 +/- 16.7 vs. 54.4 +/- 13.6 cm/s). This study clinically validates our previous numerical experiment showing that Vp is insensitive to small perturbations of the scanline through the mitral valve. However, further investigation is necessary to examine the impact of ventricular geometry in pathologies including dilated cardiomyopathy.

  1. Effect of scanline orientation on ventricular flow propagation: assessment using high frame-rate color Doppler echocardiography

    NASA Technical Reports Server (NTRS)

    Greenberg, N. L.; Castro, P. L.; Drinko, J.; Garcia, M. J.; Thomas, J. D.

    2000-01-01

    Color M-mode echocardiography has recently been utilized to describe diastolic flow propagation velocity (Vp) in the left ventricle. While increasing temporal resolution from 15 to 200 Hz, this M-mode technique requires the user to select a single scanline, potentially limiting quantification of Vp due to the complex three-dimensional inflow pattern. We previously performed computational fluid dynamics simulations to demonstrate the insignificance of the scanline orientation, however geometric complexity was limited. The purpose of this study was to utilize high frame-rate 2D color Doppler images to investigate the importance of scanline selection in patients for the quantification of Vp. 2D color Doppler images were digitally acquired at 50 frames/s in 6 subjects from the apical 4-chamber window (System 5, GE/Vingmed, Milwaukee, WI). Vp was determined for a set of scanlines positioned through 5 locations across the mitral annulus (from the anterior to posterior mitral annulus). An analysis of variance was performed to examine the differences in Vp as a function of scanline position. Vp was not effected by scanline position in sampled locations from the center of the mitral valve towards the posterior annulus. Although not statistically significant, there was a trend to slower propagation velocities on the anterior side of the valve (60.8 +/- 16.7 vs. 54.4 +/- 13.6 cm/s). This study clinically validates our previous numerical experiment showing that Vp is insensitive to small perturbations of the scanline through the mitral valve. However, further investigation is necessary to examine the impact of ventricular geometry in pathologies including dilated cardiomyopathy.

  2. Contrast-enhanced ultrasound in ovarian tumors – diagnostic parameters: method presentation and initial experience

    PubMed Central

    MAXIM, ANITA-ROXANA; BADEA, RADU; TAMAS, ATILLA; TRAILA, ALEXANDRU

    2013-01-01

    The aim of this paper is to discuss and illustrate the use of contrast-enhanced ultrasound in evaluating ovarian tumors compared to conventional ultrasound, Doppler ultrasound and the histopathological analysis and suggest how this technique may best be used to distinguish benign from malignant ovarian masses. We present the method and initial experience of our center by analyzing the parameters used in contrast-enhanced ultrasound in 6 patients with ovarian tumors of uncertain etiology. For examination we used a Siemens ultrasound machine with dedicated contrast software and the contrast agent SonoVue, Bracco. The patients underwent conventional ultrasound, Doppler ultrasound and i.v. administration of the contrast agent. The parameters studied were: inflow of contrast (rise time), time to peak enhancement, mean transit time. The series of patients is part of an extensive prospective PhD study aimed at elaborating a differential diagnosis protocol for benign versus malignant ovarian tumors, by validating specific parameters for contrast-enhanced ultrasound. Although the method is currently used with great success in gastroenterology, urology and senology, its validation in gynecology is still in the early phases. Taking into consideration that the method is minimally invasive and much less costly that CT/MRI imaging, demonstrating its utility in oncologic gynecology would be a big step in preoperative evaluation of these cases. PMID:26527912

  3. Assessment of the Effects of Low-Level Laser Therapy on the Thyroid Vascularization of Patients with Autoimmune Hypothyroidism by Color Doppler Ultrasound

    PubMed Central

    Höfling, Danilo Bianchini; Chavantes, Maria Cristina; Juliano, Adriana G.; Cerri, Giovanni G.; Knobel, Meyer; Yoshimura, Elisabeth M.; Chammas, Maria Cristina

    2012-01-01

    Background. Chronic autoimmune thyroiditis (CAT) frequently alters thyroid vascularization, likely as a result of the autoimmune process. Objective. To evaluate the effects of low-level laser therapy (LLLT) on the thyroid vascularization of patients with hypothyroidism induced by CAT using color Doppler ultrasound parameters. Methods. In this randomized clinical trial, 43 patients who underwent levothyroxine replacement for CAT-induced hypothyroidism were randomly assigned to receive either 10 sessions of LLLT (L group, n = 23) or 10 sessions of a placebo treatment (P group, n = 20). Color Doppler ultrasounds were performed before and 30 days after interventions. To verify the vascularity of the thyroid parenchyma, power Doppler was performed. The systolic peak velocity (SPV) and resistance index (RI) in the superior (STA) and inferior thyroid arteries (ITAs) were measured by pulsed Doppler. Results. The frequency of normal vascularization of the thyroid lobes observed in the postintervention power Doppler examination was significantly higher in the L than in the P group (P = 0.023). The pulsed Doppler examination revealed an increase in the SPV of the ITA in the L group compared with the P group (P = 0.016). No significant differences in the SPV of the STA and in the RI were found between the groups. Conclusion. These results suggest that LLLT can ameliorate thyroid parenchyma vascularization and increase the SPV of the ITA of patients with hypothyroidism caused by CAT. PMID:23316383

  4. Automated assessment of mitral regurgitant volume and regurgitant fraction by a newly developed digital color Doppler velocity profile integration method.

    PubMed

    Hozumi, T; Yoshida, K; Akasaka, T; Takagi, T; Yamamuro, A; Yagi, T; Yoshikawa, J

    1997-11-15

    Recent development of the automated cardiac flow measurement (ACFM) method has provided automated measurement of stroke volume and cardiac output by spatial and temporal integration of digital Doppler velocity profile data. The purpose of this study was to evaluate the clinical usefulness of the ACFM method using digital color Doppler velocity profile integration in the assessment of mitral regurgitant volume and regurgitant fraction from measurements of both aortic outflow and mitral inflow volumes. We calculated both aortic outflow and mitral inflow volumes from the apical approach with the ACFM and pulsed Doppler (PD) methods in 20 patients with isolated mitral regurgitation. Mitral regurgitant volume and regurgitant fraction were calculated by the following equation: mitral regurgitant volume = (mitral inflow volume) - (aortic outflow volume), % regurgitant fraction = (mitral regurgitant volume)/(mitral inflow volume) x 100. Mitral regurgitant volume and regurgitant fraction were compared with that determined by the PD method. Mitral regurgitant volume measurement by the ACFM method showed a good correlation with that measured by the PD method (r = 0.90, y = 0.77x + 11.6, SEE = 9.0 ml); the mean differences between PD and ACFM measurements was -1.7 +/- 12.5 ml. Regurgitant fraction estimated by the ACFM method correlated well with that of the PD method (r = 0.92, y = 0.98x + 2.1, SEE = 8.8%). The mean difference for the measurement of regurgitant fraction between the PD and ACFM methods was 0.8 +/- 6.6%. Total time required for mitral regurgitant volume calculation in 1 cardiac cycle by the ACFM method was significantly shorter than that of the PD method (126 +/- 15 seconds vs 228 +/- 36 seconds, p <0.01). In conclusion, the newly developed ACFM method is simple, quick, and accurate in the automated assessment of mitral regurgitant volume and regurgitant fraction.

  5. Diagnostic value of color doppler ultrasonography in detecting stenosis and occlusion of central veins in patients with chronic kidney disease.

    PubMed

    Rad, Masoud Pezeshki; Kazemzadeh, Gholam Hosain; Ziaee, Masood; Azarkar, Ghodsieh

    2015-03-01

    Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis. In this descriptive-analytical study, 41 hemodialysis patients who had been referred for 50 upper limb venographies to the radiology department of Imam Reza (AS) were included. Patients with chronic kidney disease with a history of catheterization of the vein, jugular or subclavian, and who had established fistulas or synthetic vascular grafts were targeted. Central venous ultrasound was performed on both sides to evaluate stenosis or occlusion. Venography was performed by the radiologist the next day or the day before hemodialysis. Data on demographic characteristics, findings of clinical examination and findings of ultrasound as well as venography were recorded by using the SPSS software, Chi-square test and Spearman correlation, and Kappa agreement was calculated for sensitivity, specificity and predictive values. Twenty-three (56%) patients were male subjects and 18 patients (44%) were female. Twenty-three (56%) patients of the study population were aged <60 years and 18 (43/9%) patients were aged >60 years. The overall sensitivity, specificity and positive predictive value and negative predictive value of Doppler sonography in the proximal veins in hemodialysis patients compared with venography were, respectively, 80.9%, 79.3%, 73.9% and 85.1%. Color Doppler sonography, as a non-invasive method, could be a good alternative for venography in the assessment of the upper limb with central vein stenosis and occlusion.

  6. High-flow-velocity and shear-rate imaging by use of color Doppler optical coherence tomography.

    PubMed

    van Leeuwen, T G; Kulkarni, M D; Yazdanfar, S; Rollins, A M; Izatt, J A

    1999-11-15

    Color Doppler optical coherence tomography (CDOCT) is capable of precise velocity mapping in turbid media. Previous CDOCT systems based on the short-time Fourier transform have been limited to maximum flow velocities of the order of tens of millimeters per second. We describe a technique, based on interference signal demodulation at multiple frequencies, to extend the physiological relevance of CDOCT by increasing the dynamic range of measurable velocities to hundreds of millimeters per second. The physiologically important parameter of shear rate is also derived from CDOCT measurements. The measured flow-velocity profiles and shear-rate distributions correlate very well with theoretical predictions. The multiple demodulation technique, therefore, may be useful to monitor blood flow in vivo and to identify regions with high and low shear rates.

  7. Determination of Testicular Blood Flow in Camelids Using Vascular Casting and Color Pulsed-Wave Doppler Ultrasonography

    PubMed Central

    Kutzler, Michelle; Tyson, Reid; Grimes, Monica; Timm, Karen

    2011-01-01

    We describe the vasculature of the camelid testis using plastic casting. We also use color pulsed-wave Doppler ultrasonography to measure testicular blood flow and compare the differences between testicular blood flow in fertile and infertile camelids. The testicular artery originates from the ventral surface of the aorta, gives rise to an epididymal branch, and becomes very tortuous as it approaches the testis. Within the supratesticular arteries, peak systolic velocity (PSV) was higher in fertile males compared to infertile males (P = 0.0004). In addition, end diastolic velocity (EDV) within the supratesticular arteries was higher for fertile males when compared to infertile males (P = 0.0325). Within the marginal arteries, PSV was also higher in fertile males compared to infertile males (P = 0.0104). However, EDV within the marginal arteries was not significantly different between fertile and infertile males (P = 0.121). In addition, the resistance index was not significantly different between fertile and infertile males within the supratesticular (P = 0.486) and marginal arteries (P = 0.144). The significance of this research is that in addition to information obtained from a complete reproductive evaluation, a male camelid's fertility can be determined using testicular blood flow measured by Doppler ultrasonography. PMID:21941690

  8. Ultrahigh-velocity resolution imaging of the microcirculation in-vivo using color Doppler optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Yazdanfar, Siavash; Rollins, Andrew M.; Izatt, Joseph A.

    2001-05-01

    Color Doppler optical coherence tomography (CDOCT) is a method for noninvasive cross-sectional imaging of blood flow in vivo. In previous implementations, velocity estimates were obtained by measuring the frequency shift of discrete depth-resolved backscatter spectra, resulting in a velocity resolution on the order of 1 mm/s. We present a novel processing method that detects Doppler shifts calculated across sequential axial scans, enabling ultrahigh velocity resolution (~1 micron/s) flow measurement in scattering media. This method of sequential scan processing was calibrated with a moving mirror mounted on a precision motorized translator. Latex microspheres suspended in deuterium oxide were used as a highly scattering test phantom. Laminar flow profiles down to ~15 micron/s centerline velocity (0.02 cc/hr) were observed with a sensitivity of 1.2 micron/s. Finally, vessels on the order of 10 microns in diameter were imaged in living human skin, with a relative frequency sensitivity less than 4 x 10-5. To our knowledge, these results are the lowest velocities ever measured with CDOCT.

  9. Comparison of color-Doppler and qualitative and quantitative strain-elastography for differentiation of thyroid nodules in daily practice.

    PubMed

    Götzberger, Manuela; Krueger, Susanne; Gärtner, Roland; Reincke, Martin; Pichler, Matthias; Assmann, Gerald; Mussack, Thomas; Zimmermann, Michael; Gülberg, Veit

    2016-04-01

    Strain-elastography provides a new ultrasound-based method that can offer information about the stiffness of thyroid nodules as an indicator of malignancy. The aim of our study was to compare the utility of color-Doppler and strain-elastography in differentiating between benign and malignant nodules. 77 thyroid nodules (70 benign and 7 malignant) from 70 unselected patients (48 female/22 male, mean age 49.7±14.3 years) were evaluated with color-Doppler and elastography based on a five-scale elastogram score for qualitative elastography and strain ratio for quantitative elastography. As reference tissue we chose normal thyroid tissue [strain ratio a (SR a)] and cervical muscles [strain ratio b (SR b)]. The cytological or histological results were used as a reference standard. Diagnostic performances of qualitative and quantitative elastography were compared using ROC curves. Vascularization score 3 or 4 was associated with malignancy (p=0.024) as well as elastogram score 4 or 5 (p=0.070, n.s.s.). SR a was indicatively higher and SR b lower in the group of malignant nodules (p=0.065 and p=0.246, n.s.s.). The best cut-off points predicting malignancy were 3.32 for SR a (66.7% sensitivity, 83.3% specificity) and 0.10 for SR b (71.4% sensitivity, 67.1% specificity). In our study, the accuracy of elastography did not surpass other sonographic parameters in differentiating thyroid nodules. The technique can play a role as a supplementary parameter in assessment of malignancy to improve diagnostic efficacy. The best parameter is SR a, but SR b can serve as an alternative if SR a is not assessable.

  10. Standardization of the first-trimester fetal cardiac examination using spatiotemporal image correlation with tomographic ultrasound and color Doppler imaging.

    PubMed

    Turan, S; Turan, O M; Ty-Torredes, K; Harman, C R; Baschat, A A

    2009-06-01

    The challenges of the first-trimester examination of the fetal heart may in part be overcome by technical advances in three-dimensional (3D) ultrasound techniques. Our aim was to standardize the first-trimester 3D imaging approach to the cardiac examination to provide the most consistent and accurate display of anatomy. Low-risk women with normal findings on first-trimester screening at 11 to 13 + 6 weeks had cardiac ultrasound using the following sequence: (1) identification of the four-chamber view; (2) four-dimensional (4D) volume acquisition with spatiotemporal image correlation (STIC) and color Doppler imaging (angle = 20 degrees, sweep 10 s); (3) offline, tomographic ultrasound imaging (TUI) analysis with standardized starting plane (four-chamber view), slice number and thickness; (4) assessment of fetal cardiac anatomy (four-chamber view, cardiac axis, size and symmetry, atrioventricular valves, great arteries and descending aorta) with and without color Doppler. 107 consecutive women (age, 16-42 years, body mass index 17.2-50.2 kg/m(2)) were studied. A minimum of three 3D volumes were obtained for each patient, transabdominally in 91.6%. Fetal motion artifact required acquisition of more than three volumes in 20%. The median time for TUI offline analysis was 100 (range, 60-240) s. Individual anatomic landmarks were identified in 89.7-99.1%. Visualization of all structures in one panel was observed in 91 patients (85%). Starting from a simple two-dimensional cardiac landmark-the four-chamber view-the standardized STIC-TUI technique enables detailed segmental cardiac evaluation of the normal fetal heart in the first trimester. (c) 2009 ISUOG.

  11. [Association between carotid lesions evaluated by Doppler color echocardiography and cardiovascular risk factors in the elderly. Preliminary results].

    PubMed

    Binaghi, F; Fronteddu, P F; Putzu, V; Cannas, F; Pitzus, F

    1998-01-01

    The valuation of the extracranial carotid by echo color-Doppler takes on an extraordinary importance for the prevention of cerebral ictus at geriatric age. In this "naturalistic" study a population of old people (> 65 yrs) of Cagliari's province was considered in order to: 1) discriminate the lesions of the carotid that are imputed to atherosclerotic disease by anatomic changes of the arterial wall caused by aging; 2) study relations between lesions of the carotid and cardiovascular risk factors. The carotids of 50 old subjects were studied by echo color-Doppler and the lesion classified in different classes of severity, according to the hemodynamic standard, comparing them with the presence of the most important cardiovascular risk factors. Hypercholesterolemia was the most frequent risk factor (76%), followed by hypertension (62%), over-weight (54%) and smoking (42%). Moreover a diffused intima-media thickening (IMT) was constant in all the subjects with values > 0.75 mm; athero-sclerotic plaques were even present in 39 subjects which only in 4 cases could be considered at risk of cerebral ischemia. A significant correlation between the severity of the lesions and levels of total cholesterol and LDL cholesterol for the male sex emerged, while for smoking only a trend of correlation has been obtained. Considering this experience it is suggested that in old subjects the presence of a diffused IMT with values > 0.75 mm must be considered as a marker of aging of the arterial wall of the carotid and not as a cardiovascular risk factor as reported in the literature for the middleaged.

  12. [Color Doppler monitoring the utero-placental-fetal circulation variety of normal pregnancy and intrauterine growth retardation].

    PubMed

    Xu, J; Wen, L; Ma, T

    1998-04-01

    To study the utero-placental-fetal circulation (UPFC) in normal pregnancy and intrauterine growth retardation (IUGR) cases. Color doppler ultrasound was used to detect UPFC in 150 second and third trimester pregnant women, of which 89 cases were normal pregnancy and 58 cases were IUGR. 3 cases were IUGR with chronic renal failure. Hemodynamical value of the umbilical artery (UmA), umbilical vein (UmV) and uterine artery (UtA) were examined directly. The indices included time average velocity (TAV), pulsatility index (PI), resistance index (RI), systolic/diastolic (S/D) ratio, blood flow volume (Q). The maternal serum estriol (E3), human placental lactogen (HPL) and plasma thromboxane B2 (TXB2)/6-keto-PGF1 alpha (6-KP) were measured simultaneously. The result shows that in normal pregnancy group UPFC is abundant gradually with increasing gestational age. In IUGR group 92.53% of cases showed that TAV and Q of UmA, UmV markedly decreased and PI, RI and S/D ratio of UmA elevated at 20 weeks of gestation. There were significant difference between the two groups, maternal serum E3, HPL level in IUGR group were significantly lower than that of the normal pregnancy group, 6-KP level reduced, and TXB2/6-KP ratio significantly increased. Using color doppler ultrasound examining hemodynamical changes of UmA, UmV and UtA could observe UPFC function directly. It is one of the best method to early diagnose and predict the prognosis of IUGR.

  13. Color Doppler monitoring of changes of utero-placental-fetal circulation in normal pregnancy and intrauterine growth retardation.

    PubMed

    Xu, J; Wen, L; Ma, T; Zhang, Y; Zhang, Q; Gao, S; Zhao, M; Wu, H; Hu, J

    1997-01-01

    The utero-placental-fetal circulation (UPFC) of 150 subjects during second and third trimester was examined by using color Doppler. Of them 89 were normal woman and 58 were patients with intrauterine growth retardation IUGR). Our results showed that UPFC was increased gradually during normal pregnant period. In IUGR patients it was revealed that TAV and Q of UmA, UmV and UtA decreased at 20th week of gestation, especially after 30th week. PI, RI and S/D ratio of UmA were increased, but TAV, Q of UmA and UmV were markly reduced, so was UtA. PI were increased, but the changes of RI, S/D ratio in UtA were not significant. Hemodynamical findings of UmA, UmV and UtA were abnormal in 92.53% of IUGR patients. Only 81.03% present abnormal S/D ratio of UmA (P < 0.01) and the difference was statistically significant. Maternal serum E3, HPL level in IUGR were significantly lower than that of the normal. 6KP level was reduced, TXB2/6KP ratio was significantly increased. TXB2/6KP ratio was markedly related with TAV, Q of UmA, UmV and UtA. Our results suggested that using color doppler ultrasound for examination of hemodynamical changes of UmA, UmV and UtA could revealed UPFC function directly. It is one of the best methods for monitoring IUGR and might be used for early diagnosis of IUGR. The main pathophysiological changes of IUGR were UPFC obstruction and placental disfunction.

  14. Contrast-enhanced MR Imaging versus Contrast-enhanced US: A Comparison in Glioblastoma Surgery by Using Intraoperative Fusion Imaging.

    PubMed

    Prada, Francesco; Vitale, Valerio; Del Bene, Massimiliano; Boffano, Carlo; Sconfienza, Luca Maria; Pinzi, Valentina; Mauri, Giovanni; Solbiati, Luigi; Sakas, Georgios; Kolev, Velizar; D'Incerti, Ludovico; DiMeco, Francesco

    2017-10-01

    Purpose To compare contrast material enhancement of glioblastoma multiforme (GBM) with intraoperative contrast-enhanced ultrasonography (US) versus that with preoperative gadolinium-enhanced T1-weighted magnetic resonance (MR) imaging by using real-time fusion imaging. Materials and Methods Ten patients with GBM were retrospectively identified by using routinely collected, anonymized data. Navigated contrast-enhanced US was performed after intravenous administration of contrast material before tumor resection. All patients underwent tumor excision with navigated intraoperative US guidance with use of fusion imaging between real-time intraoperative US and preoperative MR imaging. With use of fusion imaging, glioblastoma contrast enhancement at contrast-enhanced US (regarding location, morphologic features, margins, dimensions, and pattern) was compared with that at gadolinium-enhanced T1-weighted MR imaging. Results Fusion imaging for virtual navigation enabled matching of real-time contrast-enhanced US scans to corresponding coplanar preoperative gadolinium-enhanced T1-weighted MR images in all cases, with a positional discrepancy of less than 2 mm. Contrast enhancement of gadolinium-enhanced T1-weighted MR imaging and contrast-enhanced US was superimposable in all cases with regard to location, margins, dimensions, and morphologic features. The qualitative analysis of contrast enhancement pattern demonstrated a similar distribution in contrast-enhanced US and gadolinium-enhanced T1-weighted MR imaging in nine patients: Seven lesions showed peripheral inhomogeneous ring enhancement, and two lesions showed a prevalent nodular pattern. In one patient, the contrast enhancement pattern differed between the two modalities: Contrast-enhanced US showed enhancement of the entire bulk of the tumor, whereas gadolinium-enhanced T1-weighted MR imaging demonstrated peripheral contrast enhancement. Conclusion Glioblastoma contrast enhancement with contrast-enhanced US is

  15. [Varicose vein recurrence after surgery of the sapheno-femoral junction: color Doppler ultrasonography study].

    PubMed

    Roscitano, Giuseppe; Mirenda, Francesco; Mandolfino, Tommaso; De Caridi, Giovanni; Stilo, Francesco; Benedetto, Filippo; Spinelli, Francesco

    2003-01-01

    The aim of this study was to evaluate the accuracy and sensitivity of colour Doppler ultrasonography for the diagnosis of postoperative recurrent varicose veins in patients submitted to surgical ligation of the saphenofemoral junction with a view to classifying the recurrences according to the causes. We studied 401 lower limbs in the orthostatic position with colour Doppler ultrasonography in 318 patients (64 M and 254 F) presenting postoperative varicose vein recurrence during the follow-up (12-60 months). We evaluated the type of reflux at the inguinal level under the Valsalva manoeuvre and divided them into 5 types. We observed an incomplete crossectomy (type 1) in 23.2% of the cases; an incontinent saphenofemoral junction, intact and in an anatomical site in 12.5% (type 2); a major tributary (double saphena) originating from the common femoral vein near to the crossectomy site in 10.2% (type 3); neovascularization in 9.7% (type 4) and the presence of a number of major tributaries from the veins of the perineal and pudendal region or from the abdominal parietal veins in 44.4% (type 5). In all cases it was possible to note and classify the type of recurrence. Colour Doppler ultrasonography is an accurate, reliable tool for the diagnosis and classification of postoperative varicose vein recurrences in patients submitted to surgical obliteration of the saphenofemoral junction. It is decisive in the preoperative evaluation and follow-up of patients. In our experience, more than one half of the cases of recurrence were not due to an error of surgical technique.

  16. Contrast-enhanced ultrasonography: usefulness in the assessment of postoperative recurrence of Crohn's disease.

    PubMed

    Paredes, José María; Ripollés, Tomás; Cortés, Xavier; Moreno, Nadia; Martínez, María Jesús; Bustamante-Balén, Marco; Delgado, Fructuoso; Moreno-Osset, Eduardo

    2013-04-01

    The aim of this study was to assess whether the contrast-enhanced ultrasonography (CEUS) can increase the value of the ultrasonography in the study of postoperative recurrence of Crohn's disease (CD). 60 patients with CD who had previously undergone ileocolic resection underwent prospectively both CEUS and colonoscopy within a 3-day period. The sonographic examination included evaluation of bowel wall thickness, transmural complications, colour Doppler grade and contrast-enhanced US. In addition a sonographic score was established. The capacity of CEUS to diagnose endoscopic recurrence, as well as its severity, was assessed by calculating the sensitivity, specificity and positive and negative predictive values, accuracy and odds ratio, with their respective 95% confidence intervals. The areas under the receiver operating characteristic (ROC) curves were also calculated. 49 out of 60 patients showed endoscopic postoperative recurrence. Severe endoscopic recurrence was present in 34 patients (57%). Classic ultrasound parameters (wall thickness >3mm and colour Doppler flow) revealed an accuracy of 88.3% for the diagnosis of recurrence. Sonographic score 2, including thickness >5mm or contrast enhancement >46%, improved the results with a sensitivity, specificity and accuracy of 98%, 100% and 98.3%, respectively, in the diagnosis of endoscopic recurrence. The area under the ROC curve was 0.99, in remarkable agreement with endoscopy (k: 0.946). Sonographic score 3, including thickness >5mm, contrast enhancement >70% or fistula identified 32 out of 34 (94.1%) severe endoscopic recurrences. The area under the ROC curve was 0.836, in good agreement with endoscopy (k: 0.688). CEUS shows excellent sensitivity and specificity for the diagnosis of postoperative recurrence in CD and can also detect severe recurrences. Copyright © 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  17. Diagnosis of Pentalogy of Cantrell in the First Trimester Using Transvaginal Sonography and Color Doppler

    PubMed Central

    Türkçapar, Ayşe Figen; Sargın Oruc, Ayla; Öksüzoglu, Aysegül; Danışman, Nuri

    2015-01-01

    We report the prenatal diagnosis of Cantrell syndrome in the first trimester. During a routine transabdominal ultrasonographic examination, a midline supraumbilical abdominal wall defect including herniated liver and ectopia cordis with a large omphalocele containing the intestines and cystic hygroma was incidentally identified at the 12th week of gestation. A transvaginal sonography examination revealed a severe lumbosacral scoliosis in addition to the inability to visualize the abdominal aorta which was indicative of a severe intracardiac defect. The parents opted for pregnancy to be terminated. In this case report, we discuss the complementary role of transvaginal sonography and Doppler imaging in the diagnosis of Cantrell syndrome in early pregnancy. PMID:25802780

  18. Targeted contrast-enhanced ultrasound imaging of angiogenesis in an orthotopic mouse tumor model of renal carcinoma.

    PubMed

    Wei, Shuping; Fu, Ninghua; Sun, Yu; Yang, Zhijian; Lei, Li; Huang, Pengfei; Yang, Bin

    2014-06-01

    Previous studies have reported that microbubbles bearing targeting ligands to molecular markers of angiogenesis can be successfully detected by ultrasound imaging in various animal models of solid cancer. In the present study, we sought to investigate the activity of microbubbles targeted to vascular endothelial growth factor receptor 2 (VEGFR2) in an orthotopic model of renal cell carcinoma (RCC). Microbubbles conjugated to an anti-VEGFR2 antibody (MBV) were compared with microbubbles conjugated to an isotype control antibody (MBC) or naked microbubbles (MBN). An orthotopic mouse model of human RCC was established by surgically implanting an established tumor within the renal capsule in mice. Tumor growth and blood flow were verified by B-mode and color Doppler ultrasound imaging. VEGFR2 expression within the tumor and renal parenchyma was detected by immunohistochemistry. The duration of contrast enhancement of MBV was much longer than those of MBN and MBC when assessed over 10 min. The baseline-subtracted contrast intensity within the tumor was higher for MBV than for MBC and MBN (p < 0.01). Additionally, the contrast intensity for MBV was significantly higher in the tumor region than in normal parenchyma (p < 0.01). Microbubbles targeting VEGFR2 exhibit suitable properties for imaging angiogenesis in orthotopic models of renal cell carcinoma, with potential applications in life science research and clinical medicine. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  19. DOPPLER WEATHER SYSTEM

    SciTech Connect

    Berlin, Gary J.

    2002-08-05

    The SRS Doppler Weather System consists of a Doppler Server, A Master Server (also known as the Weather Server), several Doppler Slave Servers, and client-side software program called the Doppler Radar Client. This system is used to display near rel-time images taken from the SRS Weather Center's Doppler Radar computer. The Doppler Server is software that resides on the SRS Doppler Computer. It gathers raw data, 24-bit color weather images via screen scraping ever five minutes as requested by the Master Server. The Doppler Server then reduces the 24-bit color images to 8-bit color using a fixed color table for analysis and compression. This preserves the fidelity of the image color and arranges the colors in specific order for display. At the time of color reduction, the white color used for the city names on the background images are remapped to a different index (color) of white that the white on the weather scale. The Weather Server places a time stamp on the image, then compresses the image and passes it to all Doppler Slave servers. Each of the Doppler Slave servers mainitain a circular buffer of the eight most current images representing the last 40 minutes of weather data. As a new image is added, the oldest drops off. The Doppler Radar Client is an optional install program for any site-wide workstation. When a Client session is started, the Client requests Doppler Slave server assignment from the Master Server. Upon its initial request to the Slave Server, the Client obtains all eight current images and maintains its own circular buffer, updating its images every five minutes as the Doppler Slave is updated. Three background reference images are stored as part of the Client. The Client brings up the appropriate background image, decompresses the doppler data, and displays the doppler data on the background image.

  20. Power constrained contrast enhancement based on brightness compensated contrast-tone mapping operation

    NASA Astrophysics Data System (ADS)

    Jung, Cheolkon; Su, Haonan; Wang, Lu; Ke, Peng

    2016-09-01

    We propose power constrained contrast enhancement based on brightness compensated contrast-tone mapping operation (BCCTMO). We adopt brightness compensation to restore the original perceptual luminance and combine tone mapping with contrast enhancement to improve image quality. First, we increase pixel values to compensate for the reduced brightness caused by backlight dimming while maintaining the perceived luminance. Then we perform a contrast-tone mapping operation to reduce the information loss caused by the brightness compensation and enhance contrast in images. Finally, we conduct color scaling to reproduce natural colors. We implement BCCTMO on an Android tablet with an LCD display using mathematical approximation. Experimental results demonstrate that BCCTMO produces high-quality images while minimizing distortions and saving power compared with state-of-the-art methods.

  1. Significance of phentolamine redosing during prostaglandin E1 penile color Doppler ultrasonography in diagnosis of vascular erectile dysfunction.

    PubMed

    Arafa, Mohamed; Eid, Hazem; Shamloul, Rany

    2007-05-01

    Recently, it was reported that phentolamine redosing during penile duplex can abolish a false diagnosis of venous leakage in patients with impotence. The aim of this study is to identify any useful role of phentolamine redosing in diagnosis of venogenic impotence. Sixty-seven consecutive patients complaining of weak erection for at least 6 months were included in this study. Penile color Doppler ultrasound (CDU) was performed using a 7.5 MHz linear array transducer with a color flow mapping capability. Following intracavernous injection of 20 microg prostaglandin E1 (PGE1), all patients with persistent end diastolic velocity (EDV) >5 cm/sec with an erectile response of E3 or lower, 20 min after intracavernosal injection of PGE1, were asked to revisit our clinic for a second CDU, 2 weeks later. During initial CDU examination, all 67 patients experienced poor response to 20 microg PGE1 with their average peak systolic velocity (PSV) and EDV being 42.8 and 6.6 cm/sec, respectively. The second CDU examination had similar results to the first one. Addition of 2 mg phentolamine did not significantly change the PSV and EDV of cavernosal arteries in any of the 67 patients. In conclusion, addition of intracavernous phentolamine during PGE1 CDU examination carries no advantage over the use of PGE1 alone regarding cavernosal artery response in patients with suspected venogenic EDV.

  2. Doppler echocardiography

    SciTech Connect

    Labovitz, A.J.; Williams, G.A.

    1988-01-01

    The authors are successful in presenting a basic book on clinical quantitative Doppler echocardiography. It is not intended to be a comprehensive text, but it does cover clinical applications in a succinct fashion. Only the more common diseases in the adult are considered. The subjects are presented logically and are easy to comprehend. The illustrations are good, and the book is paperbound. The basic principles of Doppler echocardiography are presented briefly. The book ends with chapters on left ventricular function (stroke volume and cardiac output), congenital heart disease, and color Doppler echo-cardiography. There are numerous references and a good glossary and index.

  3. Direct quantification of mitral regurgitant flow volume by real-time three-dimensional echocardiography using dealiasing of color Doppler flow at the vena contracta.

    PubMed

    Plicht, Björn; Kahlert, Philipp; Goldwasser, Ranny; Janosi, Rolf-Alexander; Hunold, Peter; Erbel, Raimund; Buck, Thomas

    2008-12-01

    Real-time 3-dimensional color Doppler echocardiographic (RT3DE) imaging has recently been demonstrated to provide accurate direct measurement of vena contracta area (VCA). The quantification of mitral regurgitant (MR) flow directly at the lesion using color Doppler echocardiography, however, has been prevented because of multiple aliasing from high flow velocities. Recent studies, however, have demonstrated that flow at the vena contracta is laminar, with a narrow velocity spectrum that should allow the dealiasing of color Doppler flow velocities for the accurate measurement of MR flow. This hypothesis was tested in an in vitro flow model and initial patient application, with magnetic resonance imaging (MRI) used as a reference. In an in vitro flow model, MR jets of flow rates from 5 to 60 mL/s were produced through asymmetric orifices of 0.2 to 0.6 cm(2). From RT3DE data sets, MR flow was calculated by the automated integration of the nonaliased color Doppler velocities over the VCA, with aliasing avoided by maximum baseline shift. Aliased flow was calculated as VCA times the Nyquist velocity times the number of aliasing transitions derived from the maximum continuous-wave Doppler velocity. Total MR flow was calculated as the sum of nonaliased and aliased flow. This approach was also clinically evaluated in 23 patients for the measurement of MR stroke volume against MRI and the hemispheric and hemielliptic proximal isovelocity surface area methods. In vitro RT3DE imaging of VCA was feasible in all flow stages without color Doppler aliasing. Flow rates calculated from RT3DE data sets showed excellent correlation with actual flow rates (r = 0.99), with a mean difference of -0.05 +/- 0.5 mL/s (not significant by t test). In vivo, good correlation and agreement were found between MR stroke volume by dealiasing and MRI (r = 0.91, -1.8 +/- 7.1 mL; not significant by t test), with better correlation and agreement compared with hemispheric proximal isovelocity surface

  4. Contrast enhancement of bite mark images using the grayscale mixer in ACR in Photoshop®.

    PubMed

    Evans, Sam; Noorbhai, Suzanne; Lawson, Zoe; Stacey-Jones, Seren; Carabott, Romina

    2013-05-01

    Enhanced images may improve bite mark edge definition, assisting forensic analysis. Current contrast enhancement involves color extraction, viewing layered images by channel. A novel technique, producing a single enhanced image using the grayscale mix panel within Adobe Camera Raw®, has been developed and assessed here, allowing adjustments of multiple color channels simultaneously. Stage 1 measured RGB values in 72 versions of a color chart image; eight sliders in Photoshop® were adjusted at 25% intervals, all corresponding colors affected. Stage 2 used a bite mark image, and found only red, orange, and yellow sliders had discernable effects. Stage 3 assessed modality preference between color, grayscale, and enhanced images; on average, the 22 survey participants chose the enhanced image as better defined for nine out of 10 bite marks. The study has shown potential benefits for this new technique. However, further research is needed before use in the analysis of bite marks.

  5. Non-contrast-enhanced magnetic resonance angiography: techniques and applications.

    PubMed

    Blankholm, Anne Dorte; Ringgaard, Steffen

    2012-01-01

    Non-contrast-enhanced magnetic resonance angiography has gained renewed interest since the discovery of the association between gadolinium-based contrast agents and nephrogenic systemic fibrosis. The following article is an overview of the different magnetic resonance angiography sequences, the technical possibilities and new developments. Clinical options and recent advancements will be highlighted, and recommendations for non-contrast-enhanced magnetic resonance angiography techniques in different anatomical regions will be given. Furthermore, the authors seek to predict the future of non-contrast-enhanced magnetic resonance angiography, with special focus on patients at risk.

  6. Real-time three-dimensional color Doppler echocardiography for characterizing the spatial velocity distribution and quantifying the peak flow rate in the left ventricular outflow tract

    NASA Technical Reports Server (NTRS)

    Tsujino, H.; Jones, M.; Shiota, T.; Qin, J. X.; Greenberg, N. L.; Cardon, L. A.; Morehead, A. J.; Zetts, A. D.; Travaglini, A.; Bauer, F.; Panza, J. A.; Thomas, J. D.

    2001-01-01

    Quantification of flow with pulsed-wave Doppler assumes a "flat" velocity profile in the left ventricular outflow tract (LVOT), which observation refutes. Recent development of real-time, three-dimensional (3-D) color Doppler allows one to obtain an entire cross-sectional velocity distribution of the LVOT, which is not possible using conventional 2-D echo. In an animal experiment, the cross-sectional color Doppler images of the LVOT at peak systole were derived and digitally transferred to a computer to visualize and quantify spatial velocity distributions and peak flow rates. Markedly skewed profiles, with higher velocities toward the septum, were consistently observed. Reference peak flow rates by electromagnetic flow meter correlated well with 3-D peak flow rates (r = 0.94), but with an anticipated underestimation. Real-time 3-D color Doppler echocardiography was capable of determining cross-sectional velocity distributions and peak flow rates, demonstrating the utility of this new method for better understanding and quantifying blood flow phenomena.

  7. Real-time three-dimensional color Doppler echocardiography for characterizing the spatial velocity distribution and quantifying the peak flow rate in the left ventricular outflow tract

    NASA Technical Reports Server (NTRS)

    Tsujino, H.; Jones, M.; Shiota, T.; Qin, J. X.; Greenberg, N. L.; Cardon, L. A.; Morehead, A. J.; Zetts, A. D.; Travaglini, A.; Bauer, F.; hide

    2001-01-01

    Quantification of flow with pulsed-wave Doppler assumes a "flat" velocity profile in the left ventricular outflow tract (LVOT), which observation refutes. Recent development of real-time, three-dimensional (3-D) color Doppler allows one to obtain an entire cross-sectional velocity distribution of the LVOT, which is not possible using conventional 2-D echo. In an animal experiment, the cross-sectional color Doppler images of the LVOT at peak systole were derived and digitally transferred to a computer to visualize and quantify spatial velocity distributions and peak flow rates. Markedly skewed profiles, with higher velocities toward the septum, were consistently observed. Reference peak flow rates by electromagnetic flow meter correlated well with 3-D peak flow rates (r = 0.94), but with an anticipated underestimation. Real-time 3-D color Doppler echocardiography was capable of determining cross-sectional velocity distributions and peak flow rates, demonstrating the utility of this new method for better understanding and quantifying blood flow phenomena.

  8. Significance of clearing differentiated thyroid carcinoma lymph node by high-frequency color Doppler ultrasonography

    PubMed Central

    Liu, Bing; Qin, Huadong; Zhang, Bin; Shi, Tiefeng; Li, Chuanle; Liu, Yao; Song, Meiyue

    2017-01-01

    We compared the clinical effects and prognosis of patients receiving lymph node dissection after surgical removal of the thyroid tissues and those not receiving it after the removal. A total of 80 patients diagnosed with differentiated thyroid carcinoma (DTC) by our hospital from March 2012 to March 2014 were successively included in the study. The cases were divided into the control group (n=36 cases) and observation group (n=44 cases), and the two groups underwent total or subtotal resection of the thyroid. In the control group, patients underwent preoperative high-frequency color ultrasonography, and the most suspicious lymph node was removed. In the observation group, patients underwent preoperative high-frequency color ultrasonography, and the surgeons cleared the lymph node of the widest range. Difference in clinical effects and prognosis of the two groups were compared. After nearly a year's follow-up observation, the tumor recurrence rate of the observation group was significantly lower than that of the control group and the survival rate of the observation group was significantly higher than that of the control group (P<0.05). The rate of surgery complications and comparative difference of the two patient groups had no statistical significance (P>0.05). When comparing the data of lymphatic metastasis tested by preoperative high-frequency color ultrasonography with intraoperative diagnosed figures, sensitivity was 97.4%, specificity 33.3%, positive predictive value 90.2% and the negative predictive value 66.7%. In conclusion, removal of the lymph node for DTC patients having undergone thyroid tissue excision with preoperative high-frequency color ultrasonography can be beneficial to improve the effects along with reduction in the recurrence rate. PMID:28123550

  9. Three-dimensional transcranial ultrasound imaging with bilateral phase aberration correction of multiple isoplanatic patches: A pilot human study with microbubble contrast enhancement

    PubMed Central

    Lindsey, Brooks D.; Nicoletto, Heather A.; Bennett, Ellen R.; Laskowitz, Daniel T.; Smith, Stephen W.

    2013-01-01

    With stroke currently the second-leading cause of death globally, and 87% of all strokes classified as ischemic, the development of a fast, accessible, cost-effective approach for imaging occlusive stroke could have a significant impact on healthcare outcomes and costs. While clinical examination and standard CT alone do not provide adequate information for understanding the complex temporal events that occur during an ischemic stroke, ultrasound imaging is well-suited to the task of examining blood flow dynamics in real-time and may allow for localization of a clot. A prototype bilateral 3D ultrasound imaging system utilizing two matrix array probes on either side of the head allows for correction of skull-induced aberration throughout two entire phased array imaging volumes. We investigated the feasibility of applying this custom correction technique in 5 healthy volunteers with Definity® microbubble contrast enhancement. Subjects were scanned simultaneously via both temporal acoustic windows in 3D color flow mode. The number of color flow voxels above a common threshold increased due to aberration correction in 5/5 subjects, with a mean increase of 33.9%. The percentage of large arteries visualized in 3D color Doppler imaging increased from 46% without aberration correction to 60% with aberration correction. PMID:24239360

  10. 3-D transcranial ultrasound imaging with bilateral phase aberration correction of multiple isoplanatic patches: a pilot human study with microbubble contrast enhancement.

    PubMed

    Lindsey, Brooks D; Nicoletto, Heather A; Bennett, Ellen R; Laskowitz, Daniel T; Smith, Stephen W

    2014-01-01

    With stroke currently the second-leading cause of death globally, and 87% of all strokes classified as ischemic, the development of a fast, accessible, cost-effective approach for imaging occlusive stroke could have a significant impact on health care outcomes and costs. Although clinical examination and standard computed tomography alone do not provide adequate information for understanding the complex temporal events that occur during an ischemic stroke, ultrasound imaging is well suited to the task of examining blood flow dynamics in real time and may allow for localization of a clot. A prototype bilateral 3-D ultrasound imaging system using two matrix array probes on either side of the head allows for correction of skull-induced aberration throughout two entire phased array imaging volumes. We investigated the feasibility of applying this custom correction technique in five healthy volunteers with Definity microbubble contrast enhancement. Subjects were scanned simultaneously via both temporal acoustic windows in 3-D color flow mode. The number of color flow voxels above a common threshold increased as a result of aberration correction in five of five subjects, with a mean increase of 33.9%. The percentage of large arteries visualized by 3-D color Doppler imaging increased from 46% without aberration correction to 60% with aberration correction.

  11. Two improved forensic methods of detecting contrast enhancement in digital images

    NASA Astrophysics Data System (ADS)

    Lin, Xufeng; Wei, Xingjie; Li, Chang-Tsun

    2014-02-01

    Contrast enhancements, such as histogram equalization or gamma correction, are widely used by malicious attackers to conceal the cut-and-paste trails in doctored images. Therefore, detecting the traces left by contrast enhancements can be an effective way of exposing cut-and-paste image forgery. In this work, two improved forensic methods of detecting contrast enhancement in digital images are put forward. More specifically, the first method uses a quadratic weighting function rather than a simple cut-off frequency to measure the histogram distortion introduced by contrast enhancements, meanwhile the averaged high-frequency energy measure of his- togram is replaced by the ratio taken up by the high-frequency components in the histogram spectrum. While the second improvement is achieved by applying a linear-threshold strategy to get around the sensitivity of threshold selection. Compared with their original counterparts, these two methods both achieve better performance in terms of ROC curves and real-world cut-and-paste image forgeries. The effectiveness and improvement of the two proposed algorithms are experimentally validated on natural color images captured by commercial camera.

  12. Detection for processing history of seam insertion and contrast enhancement

    NASA Astrophysics Data System (ADS)

    Li, Jianwei; Zhao, Yao; Ni, Rongrong

    2014-11-01

    With the development of manipulations techniques of digital images, digital image forensic technology is becoming more and more necessary. However, the determination of processing history of multi-operation is still a challenge problem. In this paper, we improve the traditional seam insertion algorithm, and propose corresponding detection method. Then an algorithm that focuses on detecting the processing history of seam insertion and contrast enhancement is proposed, which can be widely used in practical image forgery. Based on comprehensive analysis, we have discovered the inherent relationship between seam insertion and contrast enhancement. Different orders of processing make different impacts on images. By using the newly proposed algorithm, both contrast enhancement followed by seam insertion and seam insertion followed by contrast enhancement can be detected correctly. Plenty of experiments have been implemented to prove the accuracy.

  13. New adaptive clutter rejection based on spectral analysis for ultrasound color Doppler imaging: phantom and in vivo abdominal study.

    PubMed

    Geunyong Park; Sunmi Yeo; Jae Jin Lee; Changhan Yoon; Hyun-Woo Koh; Hyungjoon Lim; Youngtae Kim; Hwan Shim; Yangmo Yoo

    2014-01-01

    Effective rejection of time-varying clutter originating from slowly moving vessels and surrounding tissues is important for depicting hemodynamics in ultrasound color Doppler imaging (CDI). In this paper, a new adaptive clutter rejection method based on spectral analysis (ACR-SA) is presented for suppressing nonstationary clutter. In ACR-SA, tissue and flow characteristics are analyzed by singular value decomposition and tissue acceleration of backscattered Doppler signals to determine an appropriate clutter filter from a set of clutter filters. To evaluate the ACR-SA method, 20 frames of complex baseband data were acquired by a commercial ultrasound system equipped with a research package (Accuvix V10, Samsung Medison, Seoul, Korea) using a 3.5-MHz convex array probe by introducing tissue movements to the flow phantom (Gammex 1425 A LE, Gammex, Middleton, WI, USA). In addition, 20 frames of in vivo abdominal data from five volunteers were captured. From the phantom experiment, the ACR-SA method provided 2.43 dB (p <; 0.001) and 1.09 dB ( ) improvements in flow signal-to-clutter ratio (SCR) compared to static (STA) and down-mixing (ACR-DM) methods. Similarly, it showed smaller values in fractional residual clutter area (FRCA) compared to the STA and ACR-DM methods (i.e., 2.3% versus 5.4% and 3.7%, respectively, ). The consistent improvements in SCR from the proposed ACR-SA method were obtained with the in vivo abdominal data (i.e., 4.97 dB and 3.39 dB over STA and ACR-DM, respectively). The ACR-SA method showed less than 1% FRCA values for all in vivo abdominal data. These results indicate that the proposed ACR-SA method can improve image quality in CDI by providing enhanced rejection of nonstationary clutter.

  14. New echocardiographic windows for quantitative determination of aortic regurgitation volume using color Doppler flow convergence and vena contracta

    NASA Technical Reports Server (NTRS)

    Shiota, T.; Jones, M.; Agler, D. A.; McDonald, R. W.; Marcella, C. P.; Qin, J. X.; Zetts, A. D.; Greenberg, N. L.; Cardon, L. A.; Sun, J. P.; Sahn, D. J.; Thomas, J. D.

    1999-01-01

    Color Doppler images of aortic regurgitation (AR) flow acceleration, flow convergence (FC), and the vena contracta (VC) have been reported to be useful for evaluating severity of AR. However, clinical application of these methods has been limited because of the difficulty in clearly imaging the FC and VC. This study aimed to explore new windows for imaging the FC and VC to evaluate AR volumes in patients and to validate this in animals with chronic AR. Forty patients with AR and 17 hemodynamic states in 4 sheep with strictly quantified AR volumes were evaluated. A Toshiba SSH 380A with a 3.75-MHz transducer was used to image the FC and VC. After routine echo Doppler imaging, patients were repositioned in the right lateral decubitus position, and the FC and VC were imaged from high right parasternal windows. In only 15 of the 40 patients was it possible to image clearly and measure accurately the FC and VC from conventional (left decubitus) apical or parasternal views. In contrast, 31 of 40 patients had clearly imaged FC regions and VCs using the new windows. In patients, AR volumes derived from the FC and VC methods combined with continuous velocity agreed well with each other (r = 0.97, mean difference = -7.9 ml +/- 9.9 ml/beat). In chronic animal model studies, AR volumes derived from both the VC and the FC agreed well with the electromagnetically derived AR volumes (r = 0.92, mean difference = -1.3 +/- 4.0 ml/beat). By imaging from high right parasternal windows in the right decubitus position, complementary use of the FC and VC methods can provide clinically valuable information about AR volumes.

  15. New echocardiographic windows for quantitative determination of aortic regurgitation volume using color Doppler flow convergence and vena contracta

    NASA Technical Reports Server (NTRS)

    Shiota, T.; Jones, M.; Agler, D. A.; McDonald, R. W.; Marcella, C. P.; Qin, J. X.; Zetts, A. D.; Greenberg, N. L.; Cardon, L. A.; Sun, J. P.; hide

    1999-01-01

    Color Doppler images of aortic regurgitation (AR) flow acceleration, flow convergence (FC), and the vena contracta (VC) have been reported to be useful for evaluating severity of AR. However, clinical application of these methods has been limited because of the difficulty in clearly imaging the FC and VC. This study aimed to explore new windows for imaging the FC and VC to evaluate AR volumes in patients and to validate this in animals with chronic AR. Forty patients with AR and 17 hemodynamic states in 4 sheep with strictly quantified AR volumes were evaluated. A Toshiba SSH 380A with a 3.75-MHz transducer was used to image the FC and VC. After routine echo Doppler imaging, patients were repositioned in the right lateral decubitus position, and the FC and VC were imaged from high right parasternal windows. In only 15 of the 40 patients was it possible to image clearly and measure accurately the FC and VC from conventional (left decubitus) apical or parasternal views. In contrast, 31 of 40 patients had clearly imaged FC regions and VCs using the new windows. In patients, AR volumes derived from the FC and VC methods combined with continuous velocity agreed well with each other (r = 0.97, mean difference = -7.9 ml +/- 9.9 ml/beat). In chronic animal model studies, AR volumes derived from both the VC and the FC agreed well with the electromagnetically derived AR volumes (r = 0.92, mean difference = -1.3 +/- 4.0 ml/beat). By imaging from high right parasternal windows in the right decubitus position, complementary use of the FC and VC methods can provide clinically valuable information about AR volumes.

  16. Dual-energy contrast-enhanced spectral mammography (CESM).

    PubMed

    Daniaux, Martin; De Zordo, Tobias; Santner, Wolfram; Amort, Birgit; Koppelstätter, Florian; Jaschke, Werner; Dromain, Clarisse; Oberaigner, Willi; Hubalek, Michael; Marth, Christian

    2015-10-01

    Dual-energy contrast-enhanced mammography is one of the latest developments in breast care. Imaging with contrast agents in breast cancer was already known from previous magnetic resonance imaging and computed tomography studies. However, high costs, limited availability-or high radiation dose-led to the development of contrast-enhanced spectral mammography (CESM). We reviewed the current literature, present our experience, discuss the advantages and drawbacks of CESM and look at the future of this innovative technique.

  17. Potential Cost Savings of Contrast-Enhanced Digital Mammography.

    PubMed

    Patel, Bhavika K; Gray, Richard J; Pockaj, Barbara A

    2017-06-01

    The purpose of this article is to discuss whether the sensitivity and specificity of contrast-enhanced digital mammography (CEDM) render it a viable diagnostic alternative to breast MRI. That CEDM couples low-energy images (comparable to the diagnostic quality of standard mammography) and subtracted contrast-enhanced mammograms make it a cost-effective modality and a realistic substitute for the more costly breast MRI.

  18. Application of color Doppler flow mapping to calculate orifice area of St Jude mitral valve

    NASA Technical Reports Server (NTRS)

    Leung, D. Y.; Wong, J.; Rodriguez, L.; Pu, M.; Vandervoort, P. M.; Thomas, J. D.

    1998-01-01

    BACKGROUND: The effective orifice area (EOA) of a prosthetic valve is superior to transvalvular gradients as a measure of valve function, but measurement of mitral prosthesis EOA has not been reliable. METHODS AND RESULTS: In vitro flow across St Jude valves was calculated by hemispheric proximal isovelocity surface area (PISA) and segment-of-spheroid (SOS) methods. For steady and pulsatile conditions, PISA and SOS flows correlated with true flow, but SOS and not PISA underestimated flow. These principles were then used intraoperatively to calculate cardiac output and EOA of newly implanted St Jude mitral valves in 36 patients. Cardiac output by PISA agreed closely with thermodilution (r=0.91, Delta=-0.05+/-0.55 L/min), but SOS underestimated it (r=0.82, Delta=-1.33+/-0.73 L/min). Doppler EOAs correlated with Gorlin equation estimates (r=0.75 for PISA and r=0.68 for SOS, P<0.001) but were smaller than corresponding in vitro EOA estimates. CONCLUSIONS: Proximal flow convergence methods can calculate forward flow and estimate EOA of St Jude mitral valves, which may improve noninvasive assessment of prosthetic mitral valve obstruction.

  19. Malignant thyroid nodules: comparison between color Doppler diagnosis and histological examination of surgical samples.

    PubMed

    Berni, Alberto; Tromba, Luciana; Falvo, Laura; Marchesi, Maurizio; Grilli, Paola; Peparini, Nadia

    2002-01-01

    The aim of this study was to verify the reliability of the differential diagnosis between benign and malignant thyroid nodules on the basis of vascularization. The study was conducted on 108 patients with a scintigraphically "cold" thyroid nodule, including 54 carcinomas and 54 benign nodules. All patients underwent total thyroidectomy. Diagnosis based on histological examination of the surgical specimen was compared with ultrasonographic diagnosis obtained according to a personal classification proposed by the authors. Vascular ultrasonographic investigation produced 10 false positives, 6 false negatives and 92 correct diagnoses, with 88.8% sensitivity, 81.5% specificity, an 82.7% positive predictive value and an 88% negative predictive value. It can thus be used effectively to identify the larger nodules, while it is unable to provide any indication as to their histological type. Ultrasound vascular thyroid study is a non-invasive and low-cost method and is very reliable in the differential diagnosis of cold thyroid nodules. The best ultrasonographic modality is power Doppler. Ultrasound contrast media increase vascular definition but, due to their higher cost and the longhier duration of the examination, they should only be used in the case of small nodules.

  20. Application of color Doppler flow mapping to calculate orifice area of St Jude mitral valve

    NASA Technical Reports Server (NTRS)

    Leung, D. Y.; Wong, J.; Rodriguez, L.; Pu, M.; Vandervoort, P. M.; Thomas, J. D.

    1998-01-01

    BACKGROUND: The effective orifice area (EOA) of a prosthetic valve is superior to transvalvular gradients as a measure of valve function, but measurement of mitral prosthesis EOA has not been reliable. METHODS AND RESULTS: In vitro flow across St Jude valves was calculated by hemispheric proximal isovelocity surface area (PISA) and segment-of-spheroid (SOS) methods. For steady and pulsatile conditions, PISA and SOS flows correlated with true flow, but SOS and not PISA underestimated flow. These principles were then used intraoperatively to calculate cardiac output and EOA of newly implanted St Jude mitral valves in 36 patients. Cardiac output by PISA agreed closely with thermodilution (r=0.91, Delta=-0.05+/-0.55 L/min), but SOS underestimated it (r=0.82, Delta=-1.33+/-0.73 L/min). Doppler EOAs correlated with Gorlin equation estimates (r=0.75 for PISA and r=0.68 for SOS, P<0.001) but were smaller than corresponding in vitro EOA estimates. CONCLUSIONS: Proximal flow convergence methods can calculate forward flow and estimate EOA of St Jude mitral valves, which may improve noninvasive assessment of prosthetic mitral valve obstruction.

  1. [Color Doppler identification of early diastolic turbulence in the left atrium in patients with mitral valve insufficiency: persistence of regurgitation or inertia phenomenon?].

    PubMed

    D'Angelo, G; Moro, E; Nicolosi, G L; Dall'Aglio, V; Mimo, R; Mangano, S; Zanuttini, D

    1990-08-01

    Color Doppler flow mapping represents the most recent non invasive diagnostic tool for the visualization of intracardiac blood flow. By using the color Doppler flow mapping technique, two independent observers identified the persistence of turbulence in early diastole inside the left atrium in a selected group of 8 patients (3 F and 5 M) with mitral insufficiency. All the patients had moderate or severe mitral insufficiency, due to dilated cardiomyopathy and/or ischemic cardiomyopathy and/or valvular disease. The persistence of early diastolic turbulence inside the left atrium was documented and confirmed by using 30 degrees color sector images, which show the highest possible frame rate. The frame by frame analysis facilitated the identification of two simultaneous flow velocities during early diastole, after the mitral valve was open. The first flow was anterograde and was coded as a red signal; it flowed from the mitral valve into the left ventricle and represented early diastolic left ventricular filling. The second flow was retrograde, and was coded as a blue mosaic signal, due to turbulent aliased jet, extending from the mitral valve into the left atrium, away from the transducer. The interpretation of these two dimensional color Doppler findings is uncertain. We believe, however, that these turbulent velocity signals which persist in early diastole and flow from the mitral valve into the left atrium are probably caused by inertial blood flow due to the impact of regurgitant mitral jets during the previous systole.

  2. Quantification of Shunt Volume Through Ventricular Septal Defect by Real-Time 3-D Color Doppler Echocardiography: An in Vitro Study.

    PubMed

    Zhu, Meihua; Ashraf, Muhammad; Tam, Lydia; Streiff, Cole; Kimura, Sumito; Shimada, Eriko; Sahn, David J

    2016-05-01

    Quantification of shunt volume is important for ventricular septal defects (VSDs). The aim of the in vitro study described here was to test the feasibility of using real-time 3-D color Doppler echocardiography (RT3-D-CDE) to quantify shunt volume through a modeled VSD. Eight porcine heart phantoms with VSDs ranging in diameter from 3 to 25 mm were studied. Each phantom was passively driven at five different stroke volumes from 30 to 70 mL and two stroke rates, 60 and 120 strokes/min. RT3-D-CDE full volumes were obtained at color Doppler volume rates of 15, 20 and 27 volumes/s. Shunt flow derived from RT3-D-CDE was linearly correlated with pump-driven stroke volume (R = 0.982). RT3-D-CDE-derived shunt volumes from three color Doppler flow rate settings and two stroke rate acquisitions did not differ (p > 0.05). The use of RT3-D-CDE to determine shunt volume though VSDs is feasible. Different color volume rates/heart rates under clinically/physiologically relevant range have no effect on VSD 3-D shunt volume determination.

  3. Effects of intravenous bolus injection of nicorandil on renal artery flow velocity assessed by color Doppler ultrasound.

    PubMed

    Shimamoto, Yukiko; Kubo, Takashi; Tanabe, Kazumi; Emori, Hiroki; Katayama, Yosuke; Nishiguchi, Tsuyoshi; Taruya, Akira; Kameyama, Takeyoshi; Orii, Makoto; Yamano, Takashi; Kuroi, Akio; Yamaguchi, Tomoyuki; Takemoto, Kazushi; Matsuo, Yoshiki; Ino, Yasushi; Tanaka, Atsushi; Hozumi, Takeshi; Terada, Masaki; Akasaka, Takashi

    2017-01-01

    Previous animal studies have shown that a potassium channel opener, nicorandil, provokes vasodilation in renal microvasculature and increases renal blood flow. We conducted a clinical study that aimed to evaluate the effect of nicorandil on renal artery blood flow in comparison with nitroglycerin by using color Doppler ultrasound. The present study enrolled 40 patients with stable coronary artery disease who had no renal arterial stenosis and renal parenchymal disease. The patients received intravenous administration of nicorandil (n=20) or nitroglycerin (n=20). Before and after the administration, renal artery blood flow velocity was measured by color-guided pulsed-wave Doppler. The peak-systolic, end-diastolic, and mean renal artery blood flow velocities before the administration were not different between the nicorandil group and the nitroglycerin group. The peak-systolic (79±15cm/s to 99±21cm/s, p<0.001; and 78±19cm/s to 85±19cm/s, p=0.004), end-diastolic (22±5cm/s to 28±8cm/s, p<0.001; and 24±6cm/s to 26±6cm/s, p=0.005) and mean (41±6cm/s to 49±9cm/s, p<0.001; and 43±9cm/s to 45±9cm/s, p=0.009) renal artery flow velocities increased significantly in either group. The nominal changes in the peak-systolic (20±10cm/s vs. 7±8cm/s, p<0.001), end-diastolic (5±4cm/s vs. 2±3cm/s, p=0.001), and mean (8±5cm/s vs. 2±2cm/s, p<0.001) renal artery blood flow velocities were significantly greater in the nicorandil group compared with the nitroglycerin group. Intravenous nicorandil increased renal artery blood flow velocity in comparison with nitroglycerin. Nicorandil has a significant effect on renal hemodynamics. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  4. Proximal flow convergence method by three-dimensional color Doppler echocardiography for mitral valve area assessment in rheumatic mitral stenosis.

    PubMed

    de Agustin, Jose Alberto; Mejia, Hernan; Viliani, Dafne; Marcos-Alberca, Pedro; Gomez de Diego, Jose Juan; Nuñez-Gil, Ivan Javier; Almeria, Carlos; Rodrigo, Jose Luis; Luaces, Maria; Garcia-Fernandez, Miguel Angel; Macaya, Carlos; Perez de Isla, Leopoldo

    2014-08-01

    The two-dimensional (2D) proximal isovelocity surface area (PISA) method has important technical limitations for mitral valve orifice area (MVA) assessment in mitral stenosis (MS), mainly the geometric assumptions of PISA shape and the requirement of an angle correction factor. Single-beat real-time three-dimensional (3D) color Doppler imaging allows the direct measurement of PISA without geometric assumptions or the requirement of an angle correction factor. The aim of this study was to validate this method in patients with rheumatic MS. Sixty-three consecutive patients with rheumatic MS were included. MVA was assessed using the transthoracic 2D and 3D PISA methods. Planimetry of MVA (2D and 3D) and the pressure half-time method were used as reference methods. The 3D PISA method had better correlations with the reference methods (with 2D planimetry, r = 0.85, P < .001; with 3D planimetry, r = 0.89, P < .001; and with pressure half-time, r = 0.85, P < .001) than the conventional 2D PISA method (with 2D planimetry, r = 0.63, P < .001; with 3D planimetry, r = 0.66, P < .001; and with pressure half-time, r = 0.68, P < .001). In addition, a consistent significant underestimation of MVA using the conventional 2D PISA method was observed. A high percentage (30%) of patients with nonsevere MS by 3D planimetry were misclassified by the 2D PISA method as having severe MS (effective regurgitant orifice area < 1 cm(2)). In contrast, the 3D PISA method had 94% agreement with 3D planimetry. Good intra- and interobserver agreement for 3D PISA measurements were observed, with intraclass correlation coefficients of 0.95 and 0.90, respectively. MVA assessment using PISA by single-beat real-time 3D color Doppler echocardiography is feasible in the clinical setting and more accurate than the conventional 2D PISA method. Copyright © 2014 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

  5. Temporal subtraction contrast-enhanced dedicated breast CT

    NASA Astrophysics Data System (ADS)

    Gazi, Peymon M.; Aminololama-Shakeri, Shadi; Yang, Kai; Boone, John M.

    2016-09-01

    The development of a framework of deformable image registration and segmentation for the purpose of temporal subtraction contrast-enhanced breast CT is described. An iterative histogram-based two-means clustering method was used for the segmentation. Dedicated breast CT images were segmented into background (air), adipose, fibroglandular and skin components. Fibroglandular tissue was classified as either normal or contrast-enhanced then divided into tiers for the purpose of categorizing degrees of contrast enhancement. A variant of the Demons deformable registration algorithm, intensity difference adaptive Demons (IDAD), was developed to correct for the large deformation forces that stemmed from contrast enhancement. In this application, the accuracy of the proposed method was evaluated in both mathematically-simulated and physically-acquired phantom images. Clinical usage and accuracy of the temporal subtraction framework was demonstrated using contrast-enhanced breast CT datasets from five patients. Registration performance was quantified using normalized cross correlation (NCC), symmetric uncertainty coefficient, normalized mutual information (NMI), mean square error (MSE) and target registration error (TRE). The proposed method outperformed conventional affine and other Demons variations in contrast enhanced breast CT image registration. In simulation studies, IDAD exhibited improvement in MSE (0-16%), NCC (0-6%), NMI (0-13%) and TRE (0-34%) compared to the conventional Demons approaches, depending on the size and intensity of the enhancing lesion. As lesion size and contrast enhancement levels increased, so did the improvement. The drop in the correlation between the pre- and post-contrast images for the largest enhancement levels in phantom studies is less than 1.2% (150 Hounsfield units). Registration error, measured by TRE, shows only submillimeter mismatches between the concordant anatomical target points in all patient studies. The algorithm was

  6. Temporal subtraction contrast-enhanced dedicated breast CT

    PubMed Central

    Gazi, Peymon M.; Aminololama-Shakeri, Shadi; Yang, Kai; Boone, John M.

    2016-01-01

    Purpose To develop a framework of deformable image registration and segmentation for the purpose of temporal subtraction contrast-enhanced breast CT is described. Methods An iterative histogram-based two-means clustering method was used for the segmentation. Dedicated breast CT images were segmented into background (air), adipose, fibroglandular and skin components. Fibroglandular tissue was classified as either normal or contrast-enhanced then divided into tiers for the purpose of categorizing degrees of contrast enhancement. A variant of the Demons deformable registration algorithm, Intensity Difference Adaptive Demons (IDAD), was developed to correct for the large deformation forces that stemmed from contrast enhancement. In this application, the accuracy of the proposed method was evaluated in both mathematically-simulated and physically-acquired phantom images. Clinical usage and accuracy of the temporal subtraction framework was demonstrated using contrast-enhanced breast CT datasets from five patients. Registration performance was quantified using Normalized Cross Correlation (NCC), Symmetric Uncertainty Coefficient (SUC), Normalized Mutual Information (NMI), Mean Square Error (MSE) and Target Registration Error (TRE). Results The proposed method outperformed conventional affine and other Demons variations in contrast enhanced breast CT image registration. In simulation studies, IDAD exhibited improvement in MSE(0–16%), NCC (0–6%), NMI (0–13%) and TRE (0–34%) compared to the conventional Demons approaches, depending on the size and intensity of the enhancing lesion. As lesion size and contrast enhancement levels increased, so did the improvement. The drop in the correlation between the pre- and post-contrast images for the largest enhancement levels in phantom studies is less than 1.2% (150 Hounsfield units). Registration error, measured by TRE, shows only submillimeter mismatches between the concordant anatomical target points in all patient studies

  7. Application of contrast-enhanced ultrasound before inferior vena cava filter recovery.

    PubMed

    Yan, Ji-Ping; Li, Wei-Qin; Wang, Zhen-Feng; Guo, Bian-Lian

    2017-10-01

    This study aims to investigate the clinical value of contrast-enhanced ultrasound (CEU) before temporary inferior vena cava filter (IVCF) recovery in patients with deep venous thrombosis, in order to provide ultrasound signs for the recovery of IVCF in clinical practice. The CEU manifestations of patients with deep vein thrombosis before temporary IVCF recovery were retrospectively analyzed. With the manifestations of digital subtraction angiography (DSA) or results of the surgical recovery of IVCF as the standard, the detection rate of a thrombus in IVCF was compared between conventional ultrasound and CEU, and the role of CEU in detecting complications of IVCF was analyzed. In the 103 patients with IVCF, conventional ultrasound and CEU did not reveal any filter displacement and deformation, as well as infection. In 86 patients, filters were successfully recovered under DSA. In one patient, the filter was removed surgically. In 16 patients, recovery failed or was given up, and inferior vena cava (IVC) angiography was performed. The recovery rate of IVCF was 84.5%. Among all cases, thrombi were found within the filters or around the filter in 23 patients. The detection rate of thrombi was 47.8% (11/23) by conventional ultrasound and 82.6% (19/23) by CEU, and the difference between these two methods was statistically significant (P<0.05). CEU drew a misdiagnosis of thrombus within the filter in one patient, and the diagnosis was not confirmed after the recovery of the filter. The diagnostic coincidence rate of CEU for thrombus in the IVCF was 95.1%, and the positive predictive value was 95%. In another case, the foot of the IVCF pierced out of the wall of the IVC into the intestinal wall; and this was confirmed by DSA. Hence, recovery was given up. Thrombosis is the main complication after IVCF placement. CEU revealed typical manifestations of thrombi in the IVC, and has overcome the shortcoming of color Doppler ultrasound such as angular dependence. Its detection

  8. A new method for quantification of regurgitant flow rate using color Doppler flow imaging of the flow convergence region proximal to a discrete orifice. An in vitro study.

    PubMed

    Recusani, F; Bargiggia, G S; Yoganathan, A P; Raisaro, A; Valdes-Cruz, L M; Sung, H W; Bertucci, C; Gallati, M; Moises, V A; Simpson, I A

    1991-02-01

    While color Doppler flow mapping has yielded a quick and relatively sensitive method for visualizing the turbulent jets generated in valvular insufficiency, quantification of the degree of valvular insufficiency has been limited by the dependence of visualization of turbulent jets on hemodynamic as well as instrument-related factors. Color Doppler flow imaging, however, does have the capability of reliably showing the spatial relations of laminar flows. An area where flow accelerates proximal to a regurgitant orifice is commonly visualized on the left ventricular side of a mitral regurgitant orifice, especially when imaging is performed with high gain and a low pulse repetition frequency. This area of flow convergence, where the flow stream narrows symmetrically, can be quantified because velocity and the flow cross-sectional area change in inverse proportion along streamlines centered at the orifice. In this study, a gravity-driven constant-flow system with five sharp-edged diaphragm orifices (ranging from 2.9 to 12 mm in diameter) was imaged both parallel and perpendicular to the direction of flow through the orifice. Color Doppler flow images were produced by zero shifting so that the abrupt change in display color occurred at different velocities. This "aliasing boundary" with a known velocity and a measurable radial distance from the center of the orifice was used to determine an isovelocity hemisphere such that flow rate through the orifice was calculated as 2 pi r2 x Vr, where r is the radial distance from the center of the orifice to the color change and Vr is the velocity at which the color change was noted. Using Vr values from 54 to 14 cm/sec obtained with a 3.75-MHz transducer and from 75 to 18 cm/sec obtained with a 2.5-MHz transducer, we calculated flow rates and found them to correlate with measured flow rates (r = 0.94-0.99). The slope of the regression line was closest to unity when the lowest Vr and the correspondingly largest r were used in the

  9. Efficacy of Preoperative Color Doppler Sonography of Lower Extremity Veins on Postoperative Outcomes in Candidates of Saphenectomy: A Randomized Clinical Trial.

    PubMed

    Zarepur, Rouhollah; Kargar, Saeed; Hadadzadeh, Mehdi; Hatamizadeh, Nooshin; Zarepur, Ehsan; Forouzannia, Seyed Khalil; Faraji, Reza; Sarebanhassanabadi, Mohammadtaghi

    2016-09-01

    Doppler sonography is a type of sonography used for imaging the blood flow in the vessels and heart. This technique uses ultrasound waves with high frequency. In some patient candidates for venous graft, the identification of the suitable vein is not possible with clinical examination. This study compared the effects of preoperative color Doppler sonography of lower extremity veins on the postoperative outcomes of saphenectomy. This randomized clinical trial was conducted on 100 candidates of an off-pump coronary artery bypass graft (CABG) hospitalized in Afshar Hospital in Yazd in 2015. Patients were divided into two groups: 50 patients in the study group and 50 patients in the control group. Patients in the study group underwent color Doppler sonography of lower extremity veins using the Medison 8000 Live device. Patients in the control group were assessed preoperatively by routine venous examination without undergoing color Doppler sonography. The prepping and draping methods and also the preoperative antibiotics were the same for both groups. The patients were assessed for wound infection, edema, hematoma, and DVT 2 days, 1 week, and 1 month after surgery. Data were analyzed by SPSS version 16 using t-test, Chi-square, and Fisher's exact test. The length of incision for saphenectomy was 29.20 ± 3.71 cm in the Doppler group and 28.98 ± 3.72 cm in the non-Doppler group with no significant difference between the two groups (p=0.768). The two groups were not significantly different with respect to age, gender, diabetes, hypertension, hyperlipidemia, smoking, and history of peripheral vessels disease, postoperative infection, postoperative organ edema, postoperative hematoma, and postoperative DVT. Preoperative color Doppler sonography of the saphenous vein before saphenectomy has no effect on reducing the postoperative complications, and saphenectomy on the basis of intraoperative examination of the vein course by the surgeon has acceptable consequences. The

  10. Efficacy of Preoperative Color Doppler Sonography of Lower Extremity Veins on Postoperative Outcomes in Candidates of Saphenectomy: A Randomized Clinical Trial

    PubMed Central

    Zarepur, Rouhollah; Kargar, Saeed; Hadadzadeh, Mehdi; Hatamizadeh, Nooshin; Zarepur, Ehsan; Forouzannia, Seyed Khalil; Faraji, Reza; Sarebanhassanabadi, Mohammadtaghi

    2016-01-01

    Background Doppler sonography is a type of sonography used for imaging the blood flow in the vessels and heart. This technique uses ultrasound waves with high frequency. In some patient candidates for venous graft, the identification of the suitable vein is not possible with clinical examination. Objective This study compared the effects of preoperative color Doppler sonography of lower extremity veins on the postoperative outcomes of saphenectomy. Methods This randomized clinical trial was conducted on 100 candidates of an off-pump coronary artery bypass graft (CABG) hospitalized in Afshar Hospital in Yazd in 2015. Patients were divided into two groups: 50 patients in the study group and 50 patients in the control group. Patients in the study group underwent color Doppler sonography of lower extremity veins using the Medison 8000 Live device. Patients in the control group were assessed preoperatively by routine venous examination without undergoing color Doppler sonography. The prepping and draping methods and also the preoperative antibiotics were the same for both groups. The patients were assessed for wound infection, edema, hematoma, and DVT 2 days, 1 week, and 1 month after surgery. Data were analyzed by SPSS version 16 using t-test, Chi-square, and Fisher’s exact test. Results The length of incision for saphenectomy was 29.20 ± 3.71 cm in the Doppler group and 28.98 ± 3.72 cm in the non-Doppler group with no significant difference between the two groups (p=0.768). The two groups were not significantly different with respect to age, gender, diabetes, hypertension, hyperlipidemia, smoking, and history of peripheral vessels disease, postoperative infection, postoperative organ edema, postoperative hematoma, and postoperative DVT. Conclusion Preoperative color Doppler sonography of the saphenous vein before saphenectomy has no effect on reducing the postoperative complications, and saphenectomy on the basis of intraoperative examination of the vein course by

  11. Dynamic contrast enhanced magnetic resonance imaging in chronic Achilles tendinosis.

    PubMed

    Gärdin, Anna; Brismar, Torkel B; Movin, Tomas; Shalabi, Adel

    2013-11-22

    Chronic Achilles tendinosis is a common problem. When evaluating and comparing different therapies there is a need for reliable imaging methods. Our aim was to evaluate if chronic Achilles tendinosis affects the dynamic contrast-enhancement in the tendon and its surroundings and if short-term eccentric calf-muscle training normalizes the dynamic contrast-enhancement. 20 patients with chronic Achilles tendinopathy were included. Median duration of symptoms was 31 months (range 6 to 120 months). Both Achilles tendons were examined with dynamic contrast enhanced MRI before and after a 12- week exercise programme of eccentric calf-muscle training. The dynamic MRI was evaluated in tendon, vessel and in fat ventrally of tendon. Area under the curve (AUC), time to peak of signal, signal increase per second (SI/s) and increase in signal between start and peak as a percentage (SI%) was calculated. Pain and performance were evaluated using a questionnaire. In the fat ventrally of the tendon, dynamic contrast enhancement was significantly higher in the symptomatic leg compared to the contralateral non-symptomatic leg before but not after treatment. Despite decreased pain and improved performance there was no significant change of dynamic contrast enhancement in symptomatic tendons after treatment. In Achilles tendinosis there is an increased contrast enhancement in the fat ventrally of the tendon. The lack of correlation with symptoms and the lack of significant changes in tendon contrast enhancement parameters do however indicate that dynamic enhanced MRI is currently not a useful method to evaluate chronic Achilles tendinosis.

  12. Dynamic contrast enhanced magnetic resonance imaging in chronic Achilles tendinosis

    PubMed Central

    2013-01-01

    Background Chronic Achilles tendinosis is a common problem. When evaluating and comparing different therapies there is a need for reliable imaging methods. Our aim was to evaluate if chronic Achilles tendinosis affects the dynamic contrast-enhancement in the tendon and its surroundings and if short-term eccentric calf-muscle training normalizes the dynamic contrast-enhancement. Methods 20 patients with chronic Achilles tendinopathy were included. Median duration of symptoms was 31 months (range 6 to 120 months). Both Achilles tendons were examined with dynamic contrast enhanced MRI before and after a 12- week exercise programme of eccentric calf-muscle training. The dynamic MRI was evaluated in tendon, vessel and in fat ventrally of tendon. Area under the curve (AUC), time to peak of signal, signal increase per second (SI/s) and increase in signal between start and peak as a percentage (SI%) was calculated. Pain and performance were evaluated using a questionnaire. Results In the fat ventrally of the tendon, dynamic contrast enhancement was significantly higher in the symptomatic leg compared to the contralateral non-symptomatic leg before but not after treatment. Despite decreased pain and improved performance there was no significant change of dynamic contrast enhancement in symptomatic tendons after treatment. Conclusion In Achilles tendinosis there is an increased contrast enhancement in the fat ventrally of the tendon. The lack of correlation with symptoms and the lack of significant changes in tendon contrast enhancement parameters do however indicate that dynamic enhanced MRI is currently not a useful method to evaluate chronic Achilles tendinosis. PMID:24261480

  13. Color Doppler ultrasonography: diagnosis of ectopic thyroid gland in patients with congenital hypothyroidism caused by thyroid dysgenesis.

    PubMed

    Ohnishi, Hisashi; Sato, Hirokazu; Noda, Hiromasa; Inomata, Hiroaki; Sasaki, Nozomu

    2003-11-01

    The etiology of congenital hypothyroidism (CH) may play an important role in determining disease severity, outcome, and, therefore, its treatment schedule. Radionuclide imaging (RI) is currently the most precise diagnostic technique to establish the etiology of CH. Conventional ultrasound can identify an athyrotic condition at the normal neck position and has gained acceptance for the initial evaluation of CH; however, its ability in delineating ectopic thyroid is limited. We used color Doppler ultrasonography (CDU) to assess blood flow and morphology in the detection of ectopic thyroid in 11 CH patients disclosed by neonatal screening; thyroid glands were undetectable at the normal location by gray-scale ultrasonography (GSU). The patients studied consisted of two infants for initial investigation and nine children for reevaluating the cause of CH. All of the patients underwent GSU, CDU, RI, and magnetic resonance imaging (MRI) investigation. We set RI as the defining diagnostic test for detecting ectopic thyroid and compared the imaging of CDU with those of GSU and MRI. The results of RI showed 10 ectopic thyroids and one athyreosis. In the patients with ectopic thyroid, the sensitivity of CDU, GSU, and MRI for detecting ectopic thyroid was 90, 70, and 70%, respectively. We conclude that CDU is superior to GSU and MRI for detecting ectopic thyroid and that CDU may be adopted as the diagnostic tool for the initial investigation of suspected CH.

  14. In vivo lung microvasculature visualized in three dimensions using fiber-optic color Doppler optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Lee, Anthony M. D.; Ohtani, Keishi; MacAulay, Calum; McWilliams, Annette; Shaipanich, Tawimas; Yang, Victor X. D.; Lam, Stephen; Lane, Pierre

    2013-05-01

    For the first time, the use of fiber-optic color Doppler optical coherence tomography (CDOCT) to map in vivo the three-dimensional (3-D) vascular network of airway segments in human lungs is demonstrated. Visualizing the 3-D vascular network in the lungs may provide new opportunities for detecting and monitoring lung diseases such as asthma, chronic obstructive pulmonary disease, and lung cancer. Our CDOCT instrument employs a rotary fiber-optic probe that provides simultaneous two-dimensional (2-D) real-time structural optical coherence tomography (OCT) and CDOCT imaging at frame rates up to 12.5 frames per second. Controlled pullback of the probe allows 3-D vascular mapping in airway segments up to 50 mm in length in a single acquisition. We demonstrate the ability of CDOCT to map both small and large vessels. In one example, CDOCT imaging allows assignment of a feature in the structural OCT image as a large (˜1 mm diameter) blood vessel. In a second example, a smaller vessel (˜80 μm diameter) that is indistinguishable in the structural OCT image is fully visualized in 3-D using CDOCT.

  15. Relationship between Intraventricular Flow Patterns and the Shapes of the Aliasing Area in Color M-mode Doppler Echocardiograms

    NASA Astrophysics Data System (ADS)

    Nakamura, Masanori; Wada, Shigeo; Mikami, Taisei; Kitabatake, Akira; Karino, Takeshi

    Spatiotemporal maps of the velocity of intraventricular blood flows obtained with color M-mode Doppler (CMD) echocardiography are used to assess the diastolic function of the left ventricle (LV). However, theoretical basis for that is unclear. Hence, we studied the relationship between flow patterns in the LV and the shapes of aliasing areas that appear in CMD echocardiograms by means of computational fluid dynamics using an axisymmetric model of the LV. The results showed that a ring vortex formed in the early stage of expansion and grew larger while shifting its center towards the apex of the LV, occupying a large annular space between the mainflow along the long axis and the lateral wall of the LV and constricting the mainflow. Due to that, fluid elements in the mainflow increased their velocities and proceeded further deeper into the LV with high velocities, which appeared to be an elongated shape of the aliasing area in the CMD echocardiogram. From these results it was concluded that the shape of the aliasing area in a CMD echocardiogram shows the change in the velocity of the mainflow affected by the growth and migration of a ring vortex formed in the LV.

  16. Color M-mode Doppler flow propagation velocity is a preload insensitive index of left ventricular relaxation: animal and human validation

    NASA Technical Reports Server (NTRS)

    Garcia, M. J.; Smedira, N. G.; Greenberg, N. L.; Main, M.; Firstenberg, M. S.; Odabashian, J.; Thomas, J. D.

    2000-01-01

    OBJECTIVES: To determine the effect of preload in color M-mode Doppler flow propagation velocity (v(p)). BACKGROUND: The interpretation of Doppler filling patterns is limited by confounding effects of left ventricular (LV) relaxation and preload. Color M-mode v(p) has been proposed as a new index of LV relaxation. METHODS: We studied four dogs before and during inferior caval (IVC) occlusion at five different inotropic stages and 14 patients before and during partial cardiopulmonary bypass. Left ventricular (LV) end-diastolic volumes (LV-EDV), the time constant of isovolumic relaxation (tau), left atrial (LA) pre-A and LV end-diastolic pressures (LV-EDP) were measured. Peak velocity during early filling (E) and v(p) were extracted by digital analysis of color M-mode Doppler images. RESULTS: In both animals and humans, LV-EDV and LV-EDP decreased significantly from baseline to IVC occlusion (both p < 0.001). Peak early filling (E) velocity decreased in animals from 56 +/- 21 to 42 +/- 17 cm/s (p < 0.001) without change in v(p) (from 35 +/- 15 to 35 +/- 16, p = 0.99). Results were similar in humans (from 69 +/- 15 to 53 +/- 22 cm/s, p < 0.001, and 37 +/- 12 to 34 +/- 16, p = 0.30). In both species, there was a strong correlation between LV relaxation (tau) and v(p) (r = 0.78, p < 0.001, r = 0.86, p < 0.001). CONCLUSIONS: Our results indicate that color M-mode Doppler v(p) is not affected by preload alterations and confirms that LV relaxation is its main physiologic determinant in both animals during varying lusitropic conditions and in humans with heart disease.

  17. Diagnostic performance of axial-strain sonoelastography in confirming clinically diagnosed Achilles tendinopathy: comparison with B-mode ultrasound and color Doppler imaging.

    PubMed

    Ooi, Chin Chin; Schneider, Michal Elisabeth; Malliaras, Peter; Chadwick, Martine; Connell, David Alister

    2015-01-01

    This primary aim of this study was to evaluate the diagnostic performance of axial-strain sonoelastography (ASE), B-mode ultrasound (US) and color Doppler US in confirming clinically symptomatic Achilles tendinopathy. The secondary aim was to establish the relationship between the strain ratio during sonoelastography and Victorian Institute of Sport Assessment-Achilles (VISA-A) scores. The VISA-A questionnaire is a validated clinical rating scale that evaluates the symptoms and dysfunction of the Achilles tendon. One hundred twenty Achilles tendons of 120 consecutively registered patients with clinical symptoms of Achilles tendinopathy and another 120 gender- and age-matched, asymptomatic Achilles tendons of 120 healthy volunteers were assessed with B-mode US, ASE and color Doppler US. Symptomatic patients had significantly higher strain ratio scores and softer Achilles tendon properties compared with controls (p < 0.001). The strain ratio was moderately correlated with VISA-A scores (r = -0.62, p < 0.001). The diagnostic accuracy of B-mode US, ASE and color Doppler US in confirming clinically symptomatic Achilles tendinopathy was 94.7%, 97.8% and 82.5% respectively. There was excellent correlation between the clinical reference standard and the grade of tendon quality on ASE (κ = 0.91, p < 0.05), compared with B-mode US (κ = 0.74, p < 0.05) and color Doppler imaging (κ = 0.49, p < 0.05). ASE is an accurate clinical tool in the evaluation of Achilles tendinopathy, with results comparable to those of B-mode US and excellent correlation with clinical findings. The strain ratio may offer promise as a supplementary tool for the objective evaluation of Achilles tendon properties.

  18. Direct measurement of proximal isovelocity surface area by real-time three-dimensional color Doppler for quantitation of aortic regurgitant volume: an in vitro validation.

    PubMed

    Pirat, Bahar; Little, Stephen H; Igo, Stephen R; McCulloch, Marti; Nosé, Yukihiko; Hartley, Craig J; Zoghbi, William A

    2009-03-01

    The proximal isovelocity surface area (PISA) method is useful in the quantitation of aortic regurgitation (AR). We hypothesized that actual measurement of PISA provided with real-time 3-dimensional (3D) color Doppler yields more accurate regurgitant volumes than those estimated by 2-dimensional (2D) color Doppler PISA. We developed a pulsatile flow model for AR with an imaging chamber in which interchangeable regurgitant orifices with defined shapes and areas were incorporated. An ultrasonic flow meter was used to calculate the reference regurgitant volumes. A total of 29 different flow conditions for 5 orifices with different shapes were tested at a rate of 72 beats/min. 2D PISA was calculated as 2pi r(2), and 3D PISA was measured from 8 equidistant radial planes of the 3D PISA. Regurgitant volume was derived as PISA x aliasing velocity x time velocity integral of AR/peak AR velocity. Regurgitant volumes by flow meter ranged between 12.6 and 30.6 mL/beat (mean 21.4 +/- 5.5 mL/beat). Regurgitant volumes estimated by 2D PISA correlated well with volumes measured by flow meter (r = 0.69); however, a significant underestimation was observed (y = 0.5x + 0.6). Correlation with flow meter volumes was stronger for 3D PISA-derived regurgitant volumes (r = 0.83); significantly less underestimation of regurgitant volumes was seen, with a regression line close to identity (y = 0.9x + 3.9). Direct measurement of PISA is feasible, without geometric assumptions, using real-time 3D color Doppler. Calculation of aortic regurgitant volumes with 3D color Doppler using this methodology is more accurate than conventional 2D method with hemispheric PISA assumption.

  19. Color M-mode Doppler flow propagation velocity is a preload insensitive index of left ventricular relaxation: animal and human validation

    NASA Technical Reports Server (NTRS)

    Garcia, M. J.; Smedira, N. G.; Greenberg, N. L.; Main, M.; Firstenberg, M. S.; Odabashian, J.; Thomas, J. D.

    2000-01-01

    OBJECTIVES: To determine the effect of preload in color M-mode Doppler flow propagation velocity (v(p)). BACKGROUND: The interpretation of Doppler filling patterns is limited by confounding effects of left ventricular (LV) relaxation and preload. Color M-mode v(p) has been proposed as a new index of LV relaxation. METHODS: We studied four dogs before and during inferior caval (IVC) occlusion at five different inotropic stages and 14 patients before and during partial cardiopulmonary bypass. Left ventricular (LV) end-diastolic volumes (LV-EDV), the time constant of isovolumic relaxation (tau), left atrial (LA) pre-A and LV end-diastolic pressures (LV-EDP) were measured. Peak velocity during early filling (E) and v(p) were extracted by digital analysis of color M-mode Doppler images. RESULTS: In both animals and humans, LV-EDV and LV-EDP decreased significantly from baseline to IVC occlusion (both p < 0.001). Peak early filling (E) velocity decreased in animals from 56 +/- 21 to 42 +/- 17 cm/s (p < 0.001) without change in v(p) (from 35 +/- 15 to 35 +/- 16, p = 0.99). Results were similar in humans (from 69 +/- 15 to 53 +/- 22 cm/s, p < 0.001, and 37 +/- 12 to 34 +/- 16, p = 0.30). In both species, there was a strong correlation between LV relaxation (tau) and v(p) (r = 0.78, p < 0.001, r = 0.86, p < 0.001). CONCLUSIONS: Our results indicate that color M-mode Doppler v(p) is not affected by preload alterations and confirms that LV relaxation is its main physiologic determinant in both animals during varying lusitropic conditions and in humans with heart disease.

  20. Contrast-enhanced ultrasound for imaging of adrenal masses.

    PubMed

    Dietrich, C F; Ignee, A; Barreiros, A P; Schreiber-Dietrich, D; Sienz, M; Bojunga, J; Braden, B

    2010-04-01

    The number of incidentally discovered adrenal masses is growing due to the increased use of modern high-resolution imaging techniques. However, the characterization and differentiation of benign and malignant adrenal lesions is challenging. This study aimed to evaluate contrast-enhanced ultrasound for the characterization of adrenal masses. We studied 58 patients with adrenal masses detected with computed tomography, magnetic resonance imaging, or ultrasound. 7 patients had bilateral adrenal lesions. Contrast-enhanced ultrasound was performed using high-resolution ultrasound (3.5 - 7 MHz) and intravenous injection of 2.4 ml SonoVue. The contrast enhancement pattern of all adrenal lesions was documented. The 18 malignant adrenal tumors were significantly larger at the time of diagnosis compared to the 40 benign lesions (p < 0.03). The majority of benign adrenal lesions (37 / 40) had a nonspecific type of contrast enhancement (24 / 40) or a peripheral to central contrast filling (13 / 40) described as the iris phenomenon. Similar findings were observed in malignant adrenal tumors: most malignant lesions also showed nonspecific (6 / 18) or peripheral to central contrast filling (9 / 18). Peripheral to central contrast filling had 50 % sensitivity (26 - 74 %) and 68 % specificity (51 - 81 %) for indicating malignancy. Contrast-enhanced ultrasound facilitates the visualization of vascularization even in small adrenal masses, but it does not help to distinguish malignant and benign lesions. Georg Thieme Verlag KG Stuttgart . New York.

  1. [Contrast-enhanced ultrasound findings of breast cancer].

    PubMed

    Zhang, Jian-xing; Shen, Qiang; Cai, Li-shan; Gao, Lei; Song, Guang-hui; Xie, Xiao-yan; Huang, Jie-xin

    2009-04-01

    To study the manifestation of breast cancers of different sizes in contrast-enhanced sonography. Eighty-four patients with breast cancers were examined by contrast-enhanced ultrasound. Among them, the tumor diameter was beyond 2.0 cm in 50 cases, and no greater than 2.0 cm in the rest cases. The time-intensity curve (TIC) on the enhanced images was analyzed quantitatively, and the relations between the type of TIC and the enhancement patterns of the tumors were analyzed. The enhancement patterns of the breast cancers showed significant difference between patients with tumor diameter beyond 2.0 cm and those with smaller tumors (P<0.01), but the other parameters were comparable between the two groups (P>0.05). The enhancement patterns of breast cancers differ between tumors with sizes over 2.0 cm and smaller tumors, and differential analysis is suggested in the diagnosis of breast cancer using contrast-enhanced ultrasound.

  2. Color Tissue Doppler to Analyze Fetal Cardiac Time Intervals: Normal Values and Influence of Sample Gate Size.

    PubMed

    Willruth, A M; Steinhard, J; Enzensberger, C; Axt-Fliedner, R; Gembruch, U; Doelle, A; Dimitriou, I; Fimmers, R; Bahlmann, F

    2016-02-04

    Purpose: To assess the time intervals of the cardiac cycle in healthy fetuses in the second and third trimester using color tissue Doppler imaging (cTDI) and to evaluate the influence of different sizes of sample gates on time interval values. Materials and Methods: Time intervals were measured from the cTDI-derived Doppler waveform using a small and large region of interest (ROI) in healthy fetuses. Results: 40 fetuses were included. The median gestational age at examination was 26 + 1 (range: 20 + 5 - 34 + 5) weeks. The median frame rate was 116/s (100 - 161/s) and the median heart rate 143 (range: 125 - 158) beats per minute (bpm). Using small and large ROIs, the second trimester right ventricular (RV) mean isovolumetric contraction times (ICTs) were 39.8 and 41.4 ms (p = 0.17), the mean ejection times (ETs) were 170.2 and 164.6 ms (p < 0.001), the mean isovolumetric relaxation times (IRTs) were 52.8 and 55.3 ms (p = 0.08), respectively. The left ventricular (LV) mean ICTs were 36.2 and 39.4 ms (p = 0.05), the mean ETs were 167.4 and 164.5 ms (p = 0.013), the mean IRTs were 53.9 and 57.1 ms (p = 0.05), respectively. The third trimester RV mean ICTs were 50.7 and 50.4 ms (p = 0.75), the mean ETs were 172.3 and 181.4 ms (p = 0.49), the mean IRTs were 50.2 and 54.6 ms (p = 0.03); the LV mean ICTs were 45.1 and 46.2 ms (p = 0.35), the mean ETs were 175.2 vs. 172.9 ms (p = 0.29), the mean IRTs were 47.1 and 50.0 ms (p = 0.01), respectively. Conclusion: Isovolumetric time intervals can be analyzed precisely and relatively independent of ROI size. In the near future, automatic time interval measurement using ultrasound systems will be feasible and the analysis of fetal myocardial function can become part of the clinical routine. © Georg Thieme Verlag KG Stuttgart · New York.

  3. The effect of bariatric surgery on the retrobulbar flow hemodynamic parameters in patients with obesity: color Doppler evaluation.

    PubMed

    Çekiç, Bülent; Doğan, Berna; Toslak, Iclal Erdem; Doğan, Uğur; Sağlık, Semih; Erol, Muhammed Kazım

    2017-07-31

    To evaluate the effect of weight loss on the retrobulbar hemodynamics in patients who had undergone bariatric surgery for obesity using color Doppler ultrasound (CDU) and to evaluate correlations with intraocular pressure (IOP) changes measured using Goldman applanation tonometry. Thirty-two patients were included in this prospective study. Body mass index (BMI), IOP measurements, and retrobulbar CDU examination were performed on all individuals 6 months before and after bariatric surgery. The preoperative mean BMI value was 48.8 ± 2.27 kg/m(2), and mean IOP value was 18.2 ± 2.06 mmHg. At 6 months postoperatively, mean BMI and IOP were 36.28 ± 5.41 kg/m(2) and 16.1 ± 1.81 mmHg which was statistically significantly lower than the preoperative measurements (p < 0.001). In the comparison of pre- and postoperative orbital CDU value, the preoperative OA PSV (30.16 ± 5.31 cm/s) and OA EDV (10.93 ± 3.04) values were significantly lower than the postoperative OA PSV (36.21 ± 5.56) and OA EDV (12.84 ± 3.38) values (p < 0.001 and p < 0.05, respectively). A significant correlation was determined between BMI and IOP (r = -0.443; p < 0.05). Decrease in body weight resulting from bariatric surgery performed on morbid obese patients causes alterations in both IOP and retrobulbar hemodynamics. Morbidly obese patients who undergo bariatric surgery have statistically significantly lower IOP values and increase in OA Doppler parameters (PSV, EDV) than in the preoperative period, which reflects a better retrobulbar and ocular blood flow.

  4. Could contrast-enhanced CT detect STEMI prior to electrocardiogram?

    PubMed

    Sabbagh, Chadi; Rahi, Mayda; Baz, Maria; Haddad, Fadi; Helwe, Omar; Aoun, Noel; Ibrahim, Tony; Abdo, Lynn

    2015-01-01

    We present here a case in which contrast-enhanced computed tomography (CT) was the first diagnostic tool to detect myocardial hypoperfusion in a patient with atypical symptoms and normal electrocardiogram (ECG) on admission. An ST-segment elevation was detected thereafter on a second ECG realized several minutes after CT with raised troponin levels. Percutaneous coronary intervention was performed after failure of thrombolysis and confirmed occlusion of the left anterior descending artery. Further studies are needed to evaluate the role of high-resolution contrast-enhanced CT with or without coronary angiography in the workup of suspected myocardial infarction in the setting of a normal ECG.

  5. Dynamic contrast-enhanced endoscopic ultrasound: A quantification method

    PubMed Central

    Dietrich, Christoph F.; Dong, Yi; Froehlich, Eckhart; Hocke, Michael

    2017-01-01

    Dynamic contrast-enhanced ultrasound (DCE-US) has been recently standardized by guidelines and recommendations. The European Federation of Societies for US in Medicine and Biology position paper describes the use for DCE-US. Comparatively, little is known about the use of contrast-enhanced endoscopic US (CE-EUS). This current paper reviews and discusses the clinical use of CE-EUS and DCE-US. The most important clinical use of DCE-US is the prediction of tumor response to new drugs against vascular angioneogenesis. PMID:28218195

  6. [Calculation of the mitral valve area with the proximal convergent flow method with Doppler-color in patients with mitral stenosis].

    PubMed

    Aguilar, J A; Summerson, C; Flores, D; Espinosa, R A; Enciso, R; Badui, E; Hurtado, R

    1994-01-01

    In this study we evaluate prospectively a new color Doppler method for calculating the mitral valve area based on identifying a blue-red aliasing interfase proximal to the orifice, corresponding to the flow convergence region (FCR). This method can be used to calculate areas using the continuity equation. We studied 61 patients with stenosis. The mitral valve area was calculated using pressure half-time (PHT) Doppler method which were compared with values that obtained by the FCR method, according to the following formula. AVM (cm2) = 2 pi r2 x VN/Vmax; where "r" is the FCR radius measured from the orifice to the first color aliasing (blue-red interface); VN is Nyquist velocity and Vmax is the peak flow velocity by continuous wave Doppler. Twenty three patients had pure mitral stenosis and 38 double mitral lesion. Twenty patients were on sinus rhythm while 41 in atrial fibrillation. Calculated mitral valve area using the FCR method correlated well with mitral valve area determined by PHT method at a correlation coefficient of r = 0.96 (y = 0.097 x + 54.9, SEE = 0.10 cm2, p < 0.001). MVA by FCR ranged from 0.4 to 2.5 cm2 (mean = 1.19 cm2). MVA by PHT ranged from 0.42 to 2.48 cm2 (mean = 1.15 cm2). Color Doppler FCR method provides an accurate estimate of effective mitral valve area and may be useful as an alternative to the pressure half-time method. The calculated mitral valve area by the FCR method is not influenced by the presence of mitral regurgitation nor atrial fibrillation.

  7. Diagnostic value of color Doppler ultrasonography of temporal arteries and large vessels in giant cell arteritis: a consecutive case series.

    PubMed

    Diamantopoulos, Andreas P; Haugeberg, Glenn; Hetland, Helene; Soldal, Dag M; Bie, Rolf; Myklebust, Geirmund

    2014-01-01

    Color Doppler ultrasonography (CDUS) can detect inflammation in the vessel wall. No studies have evaluated the examination of the common carotid artery by CDUS in the diagnostics of giant cell arteritis (GCA). Our aim was to evaluate the combination of CDUS examination of the temporal, axillary, and common carotid arteries in the diagnosis of GCA. Patients ages ≥50 years who were referred to our department between April 2010 and October 2012 and suspected to have GCA were consecutively examined. A positive clinical evaluation for GCA 6 months after the first evaluation by 3 rheumatologists was considered as the gold diagnostic standard. All patients underwent CDUS of the temporal, axillary, and common carotid arteries. A biopsy of the temporal artery was performed for most patients. A total of 88 patients were assessed. Forty-six patients were diagnosed to have GCA by the defined gold standard. Forty-eight patients had a positive CDUS of the temporal artery. Forty-six patients diagnosed with GCA had a positive CDUS of the temporal, common carotid, and axillary arteries (100% sensitivity) and 4 patients had a positive CDUS without having GCA (91% specificity). Among the 39 GCA patients that underwent a biopsy, vasculitis was observed in 26 patients (66%), yielding a sensitivity of 67% and a specificity of 95%. CDUS of the common carotid, axillary, and temporal arteries had an excellent sensitivity and high specificity to diagnose GCA. CDUS has the potential to replace biopsy in ordinary clinical care without compromising on sensitivity and specificity. Copyright © 2014 by the American College of Rheumatology.

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

    PubMed Central

    Meng, Nana; Zhang, Ping; Huang, Huadong; Ma, Jinlan; Zhang, Yue; Li, Hao; Qu, Yi

    2013-01-01

    Background To analyze the diagnostic value of color Doppler imaging (CDI) of blood flow in the retrobulbar vessels of eyes with primary open-angle glaucoma (POAG). Methods Pertinent publications were retrieved from the Cochrane Central Register of Controlled Trials, PubMed and the ISI Web of Knowledge up to October 2012. Changes in peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary artery (SPCA) of POAG eyes and normal controls were evaluated by CDI. Subgroup analyses were conducted according to whether patients received IOP-lowering drugs treatment and were defined as treated and untreated. Results PSV and EDV were statistically significantly reduced in the OA of POAG eyes (P = 0.0002; P<0.00001; respectively), with significant heterogeneity (Pheterogeneity<0.00001, I2 = 94%; Pheterogeneity<0.00001, I2 = 85%; respectively). Similar results were demonstrated for the CRA (P<0.00001; respectively) and SPCA (P = 0.005; P<0.00001; respectively), with significant heterogeneities for both the CRA (Pheterogeneity<0.00001, I2 = 81%; Pheterogeneity<0.00001, I2 = 98%; respectively) and the SPCA (Pheterogeneity<0.00001, I2 = 96%; Pheterogeneity<0.00001, I2 = 93%; respectively). Significant increases in RI were found in all retrobulbar vessels (P<0.00001; respectively), with significant heterogeneities (Pheterogeneity<0.00001, I2 = 95%; Pheterogeneity<0.00001, I2 = 94%; Pheterogeneity<0.00001, I2 = 97%; respectively). Conclusions This meta-analysis suggests that CDI is a potential diagnostic tool for POAG. PMID:23675419

  9. Color Doppler analysis of uterine, spiral, and intraovarian artery blood flow before and after treatment with cabergoline in hyperprolactinemic patients.

    PubMed

    Temizkan, Osman; Temizkan, Sule; Asicioglu, Osman; Aydin, Kadriye; Kucur, Suna

    2015-01-01

    Prolactin (PRL) may have stimulatory effects on vascular resistance. We aimed to analyze uterine, spiral, and intraovarian artery blood flow by Doppler ultrasonography in hyperprolactinemic patients prior to and after treatment with cabergoline. The study was conducted in Sisli Etfal Training and Research Hospital gynecology outpatient clinic between 1 March 2010 and 30 September 2011. Twenty-four women with symptomatic hyperprolactinemia in reproduction age were included in the study. All hyperprolactinemic patients were studied prior to and following the suppression of circulating PRL levels by cabergoline. Patients were examined by standard B-mod and color transvaginal ultrasonography. Pulsality index (PI), resistance index (RI), and systolic/diastolic ratio (S/D) were recorded. The median PRL value was 86 (62-120) ng/ml before treatment and 4.0 (2.5-6.4) ng/ml after the treatment (p < 0.001). We found a significant association among PRL, uterine, spiral, and intraovarian artery RI with linear regression analysis (p < 0.001 for all three arteries). Uterine, spiral, and intraovarian artery PI (p = 0.021, p < 0.001, and p < 0.001, respectively) and RI (p = 0.001, p < 0.001, and p < 0.001, respectively) significantly decreased after cabergoline treatment. In conclusion, this is a pilot study which shows for the first time that PRL increases the uterine, endometrial, and intraovarian vascular resistance and cabergoline reverses this effect.

  10. Correlation of Transcranial Color Doppler to N20 Somatosensory Evoked Potential Detects Ischemic Penumbra in Subarachnoid Hemorrhage

    PubMed Central

    Di Pasquale, Piero; Zanatta, Paolo; Morghen, Ilaria; Bosco, Enrico; Forini, Elena

    2011-01-01

    Background: Normal subjects present interhemispheric symmetry of middle cerebral artery (MCA) mean flow velocity and N20 cortical somatosensory evoked potential (SSEP). Subarachnoid haemorrhage (SAH) can modify this pattern, since high regional brain vascular resistances increase blood flow velocity, and impaired regional brain perfusion reduces N20 amplitude. The aim of the study is to investigate the variability of MCA resistances and N20 amplitude between hemispheres in SAH. Methods: Measurements of MCA blood flow velocity (vMCA) by transcranial color-Doppler and median nerve SSEP were bilaterally performed in sixteen patients. MCA vascular changes on the compromised hemisphere were calculated as a ratio of the reciprocal of mean flow velocity (1/vMCA) to contralateral value and correlated to the simultaneous variations of interhemispheric ratio of N20 amplitude, within each subject. Data were analysed with respect to neuroimaging of MCA supplied areas. Results: Both interhemispheric ratios of 1/vMCA and N20 amplitude were detected >0.65 (p <0,01) in patients without neuroimages of injury. Both ratios became <0.65 (p <0.01) when patients showed unilateral images of ischemic penumbra and returned >0.65 if penumbra disappeared. The two ratios no longer correlated after structural lesion developed, as N20 detected in the damaged side remained pathological (ratio <0.65), whereas 1/vMCA reverted to symmetric interhemispheric state (ratio >0.65), suggesting a luxury perfusion. Conclusion: Variations of interhemispheric ratios of MCA resistance and cortical N20 amplitude correlate closely in SAH and allow identification of the reversible ischemic penumbra threshold, when both ratios become <0.65. The correlation is lost when structural damage develops. PMID:21660110

  11. [The role of color doppler ultrasonography, thyroid function and auto antibody for the screening of Graves' disease in pregnancy].

    PubMed

    Xue, M; Shi, Q L; Tan, K N; Wu, Y; Zhou, R

    2016-06-01

    To determine whether color doppler ultrasonography (CDU), thyroid function or thyroid autoimmune antibodies could identify Graves' disease in pregnancy(GDP) in pregnant patients with newly diagnosed thyrotoxicosis. It is an observational study. Sixty-eight pregnant patients with newly diagnosed thyrotoxicosis including gestational hyperthyroidism(GHT) subjects (GHT group, n=33) and GDP subjects (GDP group, n=35), and 62 age-and sex-matched healthy subjects (C1 group: pregnant, n=32, C2 group: non-pregnant, n=30) were recruited. Thyroid function, human chorionic gonadotropin(HCG), thyroid autoimmune antibodies were detected. Peak systolic velocity of the superior thyroid artery (STA-PSV) and diastole inner diameter(STA-D) of the superior thyroid artery were measured by CDU. A ROC curve was used to evaluate STA-PSV, STA-D, thyroid function and thyroid autoimmune antibodies for identification of GDP. The area under the ROC curve of STA-PSV, STA-D and thyroid stimulating hormone (TSH), free T4 (FT4) for GDP were 0.905, 0.887, 0.803 and 0.786, respectively. The optimal cut-off points of STA-PSV, STA-D, TSH and FT4 for GDP were 40 cm/s, 2.0mm, 0.03 mIU/L and 30 pmol/L with the sensitivity of 82.9%, 72.1%, 81.8%, 76.2% and specificity of 81.8%, 87.9%, 75.2%, 80.3%, respectively. Detection of STA-PSV and STA-D by CDU, as well as thyroid function, is useful in screening GDP in pregnant patients with thyrotoxicosis.

  12. Multiple sclerosis and optic nerve: an analysis of retinal nerve fiber layer thickness and color Doppler imaging parameters

    PubMed Central

    Akçam, H T; Capraz, I Y; Aktas, Z; Batur Caglayan, H Z; Ozhan Oktar, S; Hasanreisoglu, M; Irkec, C

    2014-01-01

    Purpose To compare both retinal nerve fiber layer thickness and orbital color Doppler ultrasonography parameters in patients with multiple sclerosis (MS) versus healthy controls. Methods This is an observational case–control study. Forty eyes from MS patients and twenty eyes from healthy volunteers were examined. Eyes were classified into three groups as group 1, eyes from MS patients with previous optic neuritis (n=20); group 2, eyes from MS patients without previous optic neuritis (n=20); and group 3, eyes from healthy controls (n=20). Following complete ophthalmologic examination and retinal nerve fiber layer thickness measurement for each group, blood flow velocities of posterior ciliary arteries, central retinal artery, ophthalmic artery, and superior ophthalmic vein were measured. Pourcelot index (resistive index), an indicator of peripheral vascular resistance, was also calculated. The statistical assessment was performed with the assistance of Pearson's Chi-square test, Mann–Whitney U-test, Kruskal–Wallis test, and Spearman's correlation test. Results The studied eyes exposed similar values in terms of intraocular pressure and central corneal thickness, implying no evidence in favor of glaucoma. All nerve fiber layer thickness values, except superior nasal quadrants, in group 1 were found to be significantly thinner than groups 2 and 3. Blood flow velocity and mean resistivity index parameters were similar in all the groups. Conclusions In MS patients, especially with previous optic neuritis, diminished retinal nerve fiber layer thickness was observed. Contrary to several studies in the current literature, no evidence supporting potential vascular origin of ocular involvement in MS was found. PMID:25081285

  13. [Evaluation of transvaginal ultrasonography-color Doppler energy imaging in surveillance of gynecologic malignant tumors after operation].

    PubMed

    Pei, Xiao-Qing; Xie, Yan-Jun; Zeng, Hui; Chen, Xiao-Yue; Wang, Yue; Liu, Fu-Yuan

    2004-02-01

    Transvaginal ultrasonography (TVS) and color Doppler energy imaging (CDE) have been already applied in ultrasonography diagnosis extensively, but articles about the methods in surveillance of gynecologic malignant tumors after operation are few. The objective of this study was to evaluate TVS-CDE in surveillance of gynecologic malignant tumors after operation. Fifty-four cases of gynecologic malignant tumors after operation, which were doubted as recurrent malignant tumors in clinic, were scanned with transabdominal ultrasonography (TAS), TVS, and TVS-CDE. The results were compared with that of pathology. Then their sensitivity, specificity,and accuracy were calculated, and the accuracy was compared by Chi-square test. Forty-three cases were diagnosed as malignant tumors by TAS; Forty-six cases were diagnosed as malignant tumors by TVS,and the positions, sizes, characteristics of the recurrent malignant tumors could be depicted visually. Forty-seven cases were diagnosed as malignant tumors by TVS-CDE; Not only the blood flow characteristics of masses,but also more diagnostic information than TVS were provided. The sensitivity was 81.3%, 91.7%, and 95.9%, respectively; the specificity was 33.3%,66.7%, and 83.3%, respectively; the accuracy was 75.9%, 88.9%, and 94.4%, respectively. Obviously, the accuracy of both TVS and TVS-CDE was higher than that of TAS(P< 0.05), but the accuracy of TVS and TVS-CDE was similar (P >0.05). TVS-CDE is helpful in the diagnosis of gynecologic malignant masses. It will be more effective in surveillance of recurrent gynecologic malignant tumors if it combined with CDE.

  14. Value of sagittal color Doppler ultrasonography as a supplementary tool in the differential diagnosis of fetal cleft lip and palate

    PubMed Central

    2017-01-01

    Purpose The purpose of this study was to evaluate the feasibility and usefulness of sagittal color Doppler ultrasonography (CDUS) for the diagnosis of fetal cleft lip (CL) and cleft palate (CP). Methods We performed targeted ultrasonography on 25 fetuses with CL and CP, taking coronal and axial images of the upper lip and maxillary alveolar arch in each case. The existence of defects in and malalignment of the alveolus on the axial image, hard palate defects on the midsagittal image, and flow-through defects on CDUS taken during fetal breathing or swallowing were assessed. We compared the ultrasonography findings with postnatal findings in all fetuses. Results Alveolar defects were detected in 16 out of 17 cases with CP and four out of eight cases with CL. Alveolar malalignment and hard palate defects were detected in 11 out of 17 cases and 14 out of 17 cases with CP, respectively, but not detected in any cases with CL. Communicating flow through the palate defect was detected in 11 out of 17 cases of CL with CP. The accuracy of detection in axial scans of an alveolar defect and malalignment was 80% and 76%, respectively. Accuracy of detection of in mid-sagittal images of hard palate defect and flow was 80% and 86%, respectively. The overall diagnostic accuracy of combined axial and sagittal images with sagittal CDUS was 92%. Conclusion Sagittal CDUS of the fetal hard palate is a feasible method to directly reveal hard palate bony defects and flow through defects, which may have additional value in the differential diagnosis of fetal CL and CP. PMID:27764909

  15. Spatial entropy-based global and local image contrast enhancement.

    PubMed

    Celik, Turgay

    2014-12-01

    This paper proposes a novel algorithm, which enhances the contrast of an input image using spatial information of pixels. The algorithm introduces a new method to compute the spatial entropy of pixels using spatial distribution of pixel gray levels. Different than the conventional methods, this algorithm considers the distribution of spatial locations of gray levels of an image instead of gray-level distribution or joint statistics computed from the gray levels of an image. For each gray level, the corresponding spatial distribution is computed using a histogram of spatial locations of all pixels with the same gray level. Entropy measures are calculated from the spatial distributions of gray levels of an image to create a distribution function, which is further mapped to a uniform distribution function to achieve the final contrast enhancement. The method achieves contrast improvement in the case of low-contrast images; however, it does not alter the image if the image’s contrast is high enough. Thus, it always produces visually pleasing results without distortions. Furthermore, this method is combined with transform domain coefficient weighting to achieve both local and global contrast enhancement at the same time. The level of the local contrast enhancement can be controlled. Several experiments on effects of contrast enhancement are performed. Experimental results show that the proposed algorithms produce better or comparable enhanced images than several state-of-the-art algorithms.

  16. Variational contrast enhancement guided by global and local contrast measurements for single-image defogging

    NASA Astrophysics Data System (ADS)

    Zhou, Li; Bi, Du-Yan; He, Lin-Yuan

    2015-01-01

    The visibility of images captured in foggy conditions is impaired severely by a decrease in the contrasts of objects and veiling with a characteristic gray hue, which may limit the performance of visual applications out of doors. Contrast enhancement together with color restoration is a challenging mission for conventional fog-removal methods, as the degrading effect of fog is largely dependent on scene depth information. Nowadays, people change their minds by establishing a variational framework for contrast enhancement based on a physically based analytical model, unexpectedly resulting in color distortion, dark-patch distortion, or fuzzy features of local regions. Unlike previous work, our method treats an atmospheric veil as a scattering disturbance and formulates a foggy image as an energy functional minimization to estimate direct attenuation, originating from the work of image denoising. In addition to a global contrast measurement based on a total variation norm, an additional local measurement is designed in that optimal problem for the purpose of digging out more local details as well as suppressing dark-patch distortion. Moreover, we estimate the airlight precisely by maximization with a geometric constraint and a natural image prior in order to protect the faithfulness of the scene color. With the estimated direct attenuation and airlight, the fog-free image can be restored. Finally, our method is tested on several benchmark and realistic images evaluated by two assessment approaches. The experimental results imply that our proposed method works well compared with the state-of-the-art defogging methods.

  17. Contrast enhanced ultrasound by real-time spatiotemporal filtering of ultrafast images

    NASA Astrophysics Data System (ADS)

    Desailly, Yann; Tissier, Anne-Marie; Correas, Jean-Michel; Wintzenrieth, Frédéric; Tanter, Mickaël; Couture, Olivier

    2017-01-01

    Contrast enhanced ultrasound (CEUS) takes advantage of the nonlinear behaviour of injected microbubbles. If these contrast techniques yield good specificity between bubbles and tissues, they suffer some drawbacks, inherently linked to their dependence on nonlinear content. In recent years, plane-wave ultrasound reached frame rates of up to 20 000 fps. In this study we propose a linear technique for CEUS that takes advantage of these very high frame rates to separate bubbles from tissue without requiring nonlinearities. Data-driven spatiotemporal filtering operations are used to separate different features in the image on the basis of coherence both in space and time. Such filter recently proved to improve Doppler sensitivity (Demene et al 2015 IEEE Trans. Med. Imaging 34 2271-85). In contrast with bubbles, even slow moving ones, tissues are highly coherent both in space and time. Therefore, singular value decomposition (SVD) seems to be a powerful tool for the separation of contrast agents and tissues. In this paper, we apply SVD processing to linear ultrafast ultrasound images for CEUS Doppler. The contrast levels reached by this technique were compared to those of a nonlinear gold standard sequence (PMPI Doppler) through a flow phantom study. The SVD technique reached contrast-to-tissue ratios (CTR) up to 10 dB higher in vitro, and proved to be robust in terms of probe motion and slow flow. A trial was also conducted on a transplanted human kidney, already imaged by means of power Doppler (Claudon et al 1999 Am. J. Roentgenol. 173 41-6) and microbubbles (Kay et al 2009 Clin. Radiol. 64 1081-7). Contrast levels yielded by the SVD technique measured up to 13 dB higher than those of PMPI Doppler.

  18. Changes of renal blood flow after ESWL: assessment by ASL MR imaging, contrast enhanced MR imaging, and renal resistive index.

    PubMed

    Abd Ellah, Mohamed; Kremser, Christian; Pallwein, Leo; Aigner, Friedrich; Schocke, Michael; Peschel, Reinhard; Pedross, Florian; Pinggera, Germar-Michael; Wolf, Christian; Alsharkawy, Mostafa A M; Jaschke, Werner; Frauscher, Ferdinand

    2010-10-01

    The annual incidence of stone formation is increased in the industrialised world. Extracorporeal shockwave lithotripsy is a non-invasive effective treatment of upper urinary tract stones. This study is aimed to evaluate changes of renal blood flow in patients undergoing extracorporeal shock wave lithotripsy (ESWL) by arterial spin labeling (ASL) MR imaging, contrast enhanced dynamic MR imaging, and renal resistive index (RI). Thirteen patients with nephrolithiasis were examined using MR imaging and Doppler ultrasound 12h before and 12h after ESWL. ASL sequence was done for both kidneys and followed by contrast enhanced MR imaging. In addition RI Doppler ultrasound measurements were performed. A significant increase in RI (p<0.001) was found in both treated and untreated kidneys. ASL MR imaging also showed significant changes in both kidneys (p<0.001). Contrast enhanced dynamic MR imaging did not show significant changes in the kidneys. ESWL causes changes in RI and ASL MR imaging, which seem to reflect changes in renal blood flow.

  19. Three-dimensional reconstruction of the color Doppler-imaged vena contracta for quantifying aortic regurgitation: studies in a chronic animal model.

    PubMed

    Mori, Y; Shiota, T; Jones, M; Wanitkun, S; Irvine, T; Li, X; Delabays, A; Pandian, N G; Sahn, D J

    1999-03-30

    The purpose of this study was to investigate the use of 3-dimensional (3D) reconstruction of color Doppler flow maps to image and extract the vena contracta cross-sectional area to determine the severity of aortic regurgitation (AR) in an animal model. Evaluation of the vena contracta with 2-dimensional imaging systems may not be sufficiently robust to fully characterize this region, which may be asymmetrically shaped. In 6 sheep with surgically induced chronic AR, 18 hemodynamically different states were studied. Instantaneous regurgitant flow rates were obtained by aortic and pulmonary electromagnetic flowmeters (EMFs) as reference standards, and aortic regurgitant effective orifice areas (EOAs) were determined from EMF regurgitant flow rates divided by continuous-wave (CW) Doppler velocities. Composite video data for color Doppler imaging of the aortic regurgitant flows were transferred into a TomTec computer after computer-controlled 180 degrees rotational acquisition. After the 3D data transverse to the flow jet were sectioned, the smallest proximal jet cross section was identified for direct measurement of the vena contracta area. Peak regurgitant flow rates and regurgitant stroke volumes were calculated as the product of these areas and the CW Doppler peak velocities and velocity-time integrals, respectively. There was an excellent correlation between the 3D-derived vena contracta areas and reference EOAs (r=0.99, SEE=0.01 cm2) and between 3D and reference peak regurgitant flow rates and regurgitant stroke volumes (r=0.99, difference=0.11 L/min; r=0.99, difference=1.5 mL/beat, respectively). 3D-based determination of the vena contracta cross-sectional area can provide accurate quantification of the severity of AR.

  20. Contrast-enhanced photoacoustic tomography of human joints

    NASA Astrophysics Data System (ADS)

    Tian, Chao; Keswani, Rahul K.; Gandikota, Girish; Rosania, Gus R.; Wang, Xueding

    2016-03-01

    Photoacoustic tomography (PAT) provides a unique tool to diagnose inflammatory arthritis. However, the specificity and sensitivity of PAT based on endogenous contrasts is limited. The development of contrast enhanced PAT imaging modalities in combination with small molecule contrast agents could lead to improvements in diagnosis and treatment of joint disease. Accordingly, we adapted and tested a PAT clinical imaging system for imaging the human joints, in combination with a novel PAT contrast agent derived from an FDA-approved small molecule drug. Imaging results based on a photoacoustic and ultrasound (PA/US) dual-modality system revealed that this contrast-enhanced PAT imaging system may offer additional information beyond single-modality PA or US imaging system, for the imaging, diagnosis and assessment of inflammatory arthritis.

  1. Contrast enhanced exposure strategy in multi-beam mask writing

    NASA Astrophysics Data System (ADS)

    Belic, Nikola; Hofmann, Ulrich; Klikovits, Jan; Martens, Stephan

    2013-03-01

    Since multi electron beam exposure has become a serious contender for next generation mask making, proximity- and process effect corrections (PEC) need to be adapted to this technology. With feature sizes in the order of the short-range blurs (resist and tool), contrast enhancements need to be combined with standard linearity corrections. Different PEC strategies are reviewed and compared with respect to their suitability for multi-beam exposure. This analysis recommends a hybrid approach that combines the benefits of shape- and dose PEC and is optimally applicable for multibeam exposure. Exposure results on the proof-of-concept 50keV electron multi-beam mask exposure tool (eMET POC) and a standard 50 kV vector shaped beam tool (VSB) are shown to verify that the combined PEC with overdose contrast enhancement covers the whole pattern range from isolated to opaque.

  2. Gasserian ganglion: appearance on contrast-enhanced MR.

    PubMed

    Downs, D M; Damiano, T R; Rubinstein, D

    1996-02-01

    To characterize the appearance of the gasserian ganglion on contrast-enhanced MR images. We retrospectively reviewed the MR images from 57 patients with suspected pituitary disease. These patients had undergone unenhanced and contrast-enhanced MR imaging of the sella, including evaluation of Meckel's cave. None of the patients had clinical signs or symptoms referable to the fifth cranial nerve or ganglion. Correlation was made with a previous study that compared gross anatomy with high-resolution CT scans of cadaveric specimens. A discrete semilunar enhancing structure within the inferolateral aspect of Meckel's cave was identified in 100 of the 114 caves examined; the other 14 caves had a thickened area of enhancement that blended with the dura inferolaterally. A small semilunar structure within the inferolateral aspect of Meckel's cave was also identified on CT scans of the cadaveric specimens. The gasserian ganglion enhances on MR images and should not be confused with a pathologic process.

  3. Diffeomorphic Registration of Images with Variable Contrast Enhancement

    PubMed Central

    Janssens, Guillaume; Jacques, Laurent; Orban de Xivry, Jonathan; Geets, Xavier; Macq, Benoit

    2011-01-01

    Nonrigid image registration is widely used to estimate tissue deformations in highly deformable anatomies. Among the existing methods, nonparametric registration algorithms such as optical flow, or Demons, usually have the advantage of being fast and easy to use. Recently, a diffeomorphic version of the Demons algorithm was proposed. This provides the advantage of producing invertible displacement fields, which is a necessary condition for these to be physical. However, such methods are based on the matching of intensities and are not suitable for registering images with different contrast enhancement. In such cases, a registration method based on the local phase like the Morphons has to be used. In this paper, a diffeomorphic version of the Morphons registration method is proposed and compared to conventional Morphons, Demons, and diffeomorphic Demons. The method is validated in the context of radiotherapy for lung cancer patients on several 4D respiratory-correlated CT scans of the thorax with and without variable contrast enhancement. PMID:21197460

  4. Diffeomorphic registration of images with variable contrast enhancement.

    PubMed

    Janssens, Guillaume; Jacques, Laurent; Orban de Xivry, Jonathan; Geets, Xavier; Macq, Benoit

    2011-01-01

    Nonrigid image registration is widely used to estimate tissue deformations in highly deformable anatomies. Among the existing methods, nonparametric registration algorithms such as optical flow, or Demons, usually have the advantage of being fast and easy to use. Recently, a diffeomorphic version of the Demons algorithm was proposed. This provides the advantage of producing invertible displacement fields, which is a necessary condition for these to be physical. However, such methods are based on the matching of intensities and are not suitable for registering images with different contrast enhancement. In such cases, a registration method based on the local phase like the Morphons has to be used. In this paper, a diffeomorphic version of the Morphons registration method is proposed and compared to conventional Morphons, Demons, and diffeomorphic Demons. The method is validated in the context of radiotherapy for lung cancer patients on several 4D respiratory-correlated CT scans of the thorax with and without variable contrast enhancement.

  5. Fundamentals of tracer kinetics for dynamic contrast-enhanced MRI.

    PubMed

    Koh, Tong San; Bisdas, Sotirios; Koh, Dow Mu; Thng, Choon Hua

    2011-12-01

    Tracer kinetic methods employed for quantitative analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) share common roots with earlier tracer studies involving arterial-venous sampling and other dynamic imaging modalities. This article reviews the essential foundation concepts and principles in tracer kinetics that are relevant to DCE MRI, including the notions of impulse response and convolution, which are central to the analysis of DCE MRI data. We further examine the formulation and solutions of various compartmental models frequently used in the literature. Topics of recent interest in the processing of DCE MRI data, such as the account of water exchange and the use of reference tissue methods to obviate the measurement of an arterial input, are also discussed. Although the primary focus of this review is on the tracer models and methods for T(1) -weighted DCE MRI, some of these concepts and methods are also applicable for analysis of dynamic susceptibility contrast-enhanced MRI data.

  6. Contrast enhancement of high-energy radiotherapy films.

    PubMed

    Reinstein, L E; Orton, C G

    1979-11-01

    An order-of-magnitude improvment in the contrast of high-energy localization and verification films has been achieved through the application of a simple, inexpensive, contrast enhancement technique. The method involves making reversal contact "prints" of the original film onto ordinary X-ray fi-m with equipment commonly available in any radiotherapy department. This results in "gamma multiplication". The theory as well as several applications of this effect are presented.

  7. Sequential contrast-enhanced MR imaging of the penis.

    PubMed

    Kaneko, K; De Mouy, E H; Lee, B E

    1994-04-01

    To determine the enhancement patterns of the penis at magnetic resonance (MR) imaging. Sequential contrast material-enhanced MR images of the penis in a flaccid state were obtained in 16 volunteers (12 with normal penile function and four with erectile dysfunction). Subjects with normal erectile function showed gradual and centrifugal enhancement of the corpora cavernosa, while those with erectile dysfunction showed poor enhancement with abnormal progression. Sequential contrast-enhanced MR imaging provides additional morphologic information for the evaluation of erectile dysfunction.

  8. Use of Color Doppler Ultrasonography to Measure Thyroid Blood Flow and Differentiate Graves' Disease from Painless Thyroiditis

    PubMed Central

    Hiraiwa, Tetsuya; Tsujimoto, Naoyuki; Tanimoto, Keiji; Terasaki, Jungo; Amino, Nobuyuki; Hanafusa, Toshiaki

    2013-01-01

    Backgrounds Color Doppler ultrasonography (CDU) has not yet been established as a method to investigate the pathogenesis of thyrotoxicosis. Objectives Our first objective was to determine whether the measurement of peak systolic blood-flow velocity in the superior thyroid artery (STV) and thyroid tissue blood flow (TBF) using CDU could differentiate Graves' disease (GD) from painless thyroiditis (PT). The second objective was to examine the factors mediating increased blood flow to the thyroid gland in GD. Methods Recruited patients had untreated GD or PT and visited the Department of Internal Medicine (I), Osaka Medical College, between April 1, 2006 and May 31, 2010. Age, gender, blood pressure, pulse rate, thyroid-stimulating hormone, free thyroxine, tri-iodothyronine, TSH receptor antibody and thyroid volume were evaluated in patients. In addition, bilateral measurements of STV, TBF and peak systolic velocity in the common carotid artery (CCV) were also performed. TBF was quantified by calculating the ratio of blood-flow pixels to total pixels in the region of interest using sagittal section images of the thyroid gland. Receiver-operating characteristic curve analysis was performed to determine the ability of STV and TBF measurements to differentiate GD from PT. Results For the average of STV measured on both sides, the area under the receiver-operating characteristic curve (AUC) was 0.956. For the average of TBF measured on both sides, the AUC was 0.920. At an average STV cut-off value of 43 cm/s, the sensitivity to discriminate GD from PT was 0.87 and the specificity was 1.00. At an average TBF cut-off value of 3.8%, the sensitivity was 0.71 and the specificity was 1.00. In the GD group, neither blood pressure nor pulse rate correlated with the average STV or TBF. Moreover, there was no correlation between STV and CCV or between TBF and CCV on either side. However, STV was correlated with TBF (right side: R = 0.47; left side: R = 0.52). Conclusions The

  9. 4-Dimensionally Guided 3-Dimensional Color-Doppler Ultrasonography Quantifies Carotid Artery Stenosis With High Reproducibility and Accuracy.

    PubMed

    Macharzina, Roland Richard; Kocher, Sascha; Messé, Steven R; Rutkowski, Thomas; Hoffmann, Fabian; Vogt, Matthias; Vach, Werner; Fan, Nian; Rastan, Aljoscha; Neumann, Franz-Josef; Zeller, Thomas

    2017-07-13

    The purpose was to analyze the agreement and binary accuracy of the degree of internal carotid artery stenosis (ICAS) as determined by 4-dimensionally (4D) real-time gray-scale guided 3-dimensional (3D) color-Doppler ultrasonography (3DC-US) (4D/3DC-US) compared with catheter angiography (CA) and duplex ultrasonography (DUS). This study hypothesized that 4D/3DC-US is noninferior to CA and DUS in grading ICAS in selected patients. Clinical stratification in patients with ICAS largely depends on a patient's symptomatic status and the degree of stenosis. Screening with 4D/3DC-US was prospectively performed in 93 study patients (with 122 ICASs), thus yielding 80 patients for analysis (with 103 ICASs) after excluding patients with insufficient image quality, previous revascularization, and contraindications to CA. The ultrasound examination (10 MHz) consisted of consensus conform DUS examination and independent real-time 4D-guided gray-scale views for orientation followed by static 3DC-US NASCET (North American Symptomatic Carotid Endarterectomy Trial) percent stenosis quantification using off-line multiplanar rendering. Multiplanar selective CA of the same ICASs was quantified with dedicated software in a blinded fashion. Quantitative CA of 103 stenoses with a mean degree of 65 ± 17% was compared with 4D/3DC-US, with a resulting concordance correlation coefficient of 0.89 and a standard deviation of differences (SDD) of 8.1% at a bias of +1.7%. Binary 50% and 70% stenosis detection with 4D/3DC-US revealed a sensitivity of 97% and 87%, respectively, and a specificity of 92% and 84%, respectively. Interobserver SDD for CA of 52 stenoses (7.2%) did not differ from SDD for 4D/3DC-US and CA (p = 0.274). Accuracy of 50% stenosis detection by 4D/3DC-US was tendentially higher compared with DUS (96% vs. 91%). The 4D/3DC-US method provides reliable and accurate stenosis quantification and binary classification with good diagnostic accuracy compared with CA and DUS. Copyright

  10. Contrast Enhancement Algorithm Based on Gap Adjustment for Histogram Equalization

    PubMed Central

    Chiu, Chung-Cheng; Ting, Chih-Chung

    2016-01-01

    Image enhancement methods have been widely used to improve the visual effects of images. Owing to its simplicity and effectiveness histogram equalization (HE) is one of the methods used for enhancing image contrast. However, HE may result in over-enhancement and feature loss problems that lead to unnatural look and loss of details in the processed images. Researchers have proposed various HE-based methods to solve the over-enhancement problem; however, they have largely ignored the feature loss problem. Therefore, a contrast enhancement algorithm based on gap adjustment for histogram equalization (CegaHE) is proposed. It refers to a visual contrast enhancement algorithm based on histogram equalization (VCEA), which generates visually pleasing enhanced images, and improves the enhancement effects of VCEA. CegaHE adjusts the gaps between two gray values based on the adjustment equation, which takes the properties of human visual perception into consideration, to solve the over-enhancement problem. Besides, it also alleviates the feature loss problem and further enhances the textures in the dark regions of the images to improve the quality of the processed images for human visual perception. Experimental results demonstrate that CegaHE is a reliable method for contrast enhancement and that it significantly outperforms VCEA and other methods. PMID:27338412

  11. Visual Contrast Enhancement Algorithm Based on Histogram Equalization

    PubMed Central

    Ting, Chih-Chung; Wu, Bing-Fei; Chung, Meng-Liang; Chiu, Chung-Cheng; Wu, Ya-Ching

    2015-01-01

    Image enhancement techniques primarily improve the contrast of an image to lend it a better appearance. One of the popular enhancement methods is histogram equalization (HE) because of its simplicity and effectiveness. However, it is rarely applied to consumer electronics products because it can cause excessive contrast enhancement and feature loss problems. These problems make the images processed by HE look unnatural and introduce unwanted artifacts in them. In this study, a visual contrast enhancement algorithm (VCEA) based on HE is proposed. VCEA considers the requirements of the human visual perception in order to address the drawbacks of HE. It effectively solves the excessive contrast enhancement problem by adjusting the spaces between two adjacent gray values of the HE histogram. In addition, VCEA reduces the effects of the feature loss problem by using the obtained spaces. Furthermore, VCEA enhances the detailed textures of an image to generate an enhanced image with better visual quality. Experimental results show that images obtained by applying VCEA have higher contrast and are more suited to human visual perception than those processed by HE and other HE-based methods. PMID:26184219

  12. Integration of Fuzzy and Wavelet Approaches towards Mammogram Contrast Enhancement

    NASA Astrophysics Data System (ADS)

    Khehra, B. S.; Pharwaha, A. P. S.

    2012-06-01

    Mammography is the most reliable, effective, low cost and high sensitive method for early detection of breast cancer. In breast cancer diagnosis, it is difficult for radiologists to detect the typical diagnostic signs because mammograms are low contrast and noisy images. In order to improve diagnosis accuracy, mammogram contrast enhancement technique is often used to enhance the contrast of mammogram and aid the radiologists. In this paper, a combined approach with fuzzy and wavelet towards improved enhancement of details and subtle features in digital mammogram images. The proposed contrast enhancement approach utilizes wavelet transform to decompose the mammogram, and then approximation coefficients are modified by fuzzy contrast enhancement approach and detail coefficients are by non-linear transformation. After that, inverse wavelet transform is applied on modified coefficients to obtain the enhanced mammogram. The proposed algorithm has been tested on a number of images in Digital Database for Screening Mammography (DDSM), comparing the results with histogram equalization which is a well-established image enhancement technique and Cheng's enhancement algorithm based on wavelet transform. In order to accurately assess the proposed approach, enhanced mammogram images are evaluated through objective image quality assessment parameters: information entropy, contrast and peak signal-to-noise ratio (PSNR). Experimental results of the proposed approach are quite promising.

  13. Contrast enhancement via texture region based histogram equalization

    NASA Astrophysics Data System (ADS)

    Singh, Kuldeep; Vishwakarma, Dinesh K.; Singh Walia, Gurjit; Kapoor, Rajiv

    2016-08-01

    This paper presents two novel contrast enhancement approaches using texture regions-based histogram equalization (HE). In HE-based contrast enhancement methods, the enhanced image often contains undesirable artefacts because an excessive number of pixels in the non-textured areas heavily bias the histogram. The novel idea presented in this paper is to suppress the impact of pixels in non-textured areas and to exploit texture features for the computation of histogram in the process of HE. The first algorithm named as Dominant Orientation-based Texture Histogram Equalization (DOTHE), constructs the histogram of the image using only those image patches having dominant orientation. DOTHE categories image patches into smooth, dominant or non-dominant orientation patches by using the image variance and singular value decomposition algorithm and utilizes only dominant orientation patches in the process of HE. The second method termed as Edge-based Texture Histogram Equalization, calculates significant edges in the image and constructs the histogram using the grey levels present in the neighbourhood of edges. The cumulative density function of the histogram formed from texture features is mapped on the entire dynamic range of the input image to produce the contrast-enhanced image. Subjective as well as objective performance assessment of proposed methods is conducted and compared with other existing HE methods. The performance assessment in terms of visual quality, contrast improvement index, entropy and measure of enhancement reveals that the proposed methods outperform the existing HE methods.

  14. Flow convergence flow rates from 3-dimensional reconstruction of color Doppler flow maps for computing transvalvular regurgitant flows without geometric assumptions: An in vitro quantitative flow study.

    PubMed

    Li, X; Shiota, T; Delabays, A; Teien, D; Zhou, X; Sinclair, B; Pandian, N G; Sahn, D J

    1999-12-01

    This study was designed to develop and test a 3-dimensional method for direct measurement of flow convergence (FC) region surface area and for quantitating regurgitant flows with an in vitro flow system. Quantitative methods for characterizing regurgitant flow events such as flow convergence with 2-dimensional color flow Doppler imaging systems have yielded variable results and may not be accurate enough to characterize those more complex spatial events. Four differently shaped regurgitant orifices were studied: 3 flat orifices (circular, rectangular, triangular) and a nonflat one mimicking mitral valve prolapse (all 4 orifice areas = 0.24 cm(2)) in a pulsatile flow model at 8 to 9 different regurgitant flow rates (10 to 50 mL/beat). An ultrasonic flow probe and meter were connected to the flow model to provide reference flow data. Video composite data from the color Doppler flow images of the FC were reconstructed after computer-controlled 180 degrees rotational acquisition was performed. FC surface area (S cm(2)) was calculated directly without any geometric assumptions by measuring parallel sliced flow convergence arc lengths through the FC volume and multiplying each by the slice thickness (2.5 to 3.2 mm) over 5 to 8 slices and then adding them together. Peak regurgitant flow rate (milliliters per second) was calculated as the product of 3-dimensional determined S (cm(2)) multiplied by the aliasing velocity (centimeters per second) used for color Doppler imaging. For all of the 4 shaped orifices, there was an excellent relationship between actual peak flow rates and 3-dimensional FC-calculated flow rates with the direct measurement of the surface area of FC (r = 0.99, mean difference = -7.2 to -0.81 mL/s, % difference = -5% to 0%), whereas a hemielliptic method implemented with 3 axial measurements of the flow convergence zone from 2-dimensional planes underestimated actual flow rate by mean difference = -39.8 to -18.2 mL/s, % difference = -32% to -17% for any

  15. Spontaneous rupture of a middle colic artery aneurysm arising from superior mesenteric artery dissection: Diagnosis by color Doppler ultrasonography and CT angiography.

    PubMed

    Yoo, Bo Reum; Han, Hyun Young; Cho, Young Kwon; Park, Suk Jin

    2012-05-01

    Both middle colic artery (MCA) aneurysm and spontaneous dissection of the superior mesenteric artery (SMA) are rare. We report the first case of concomitancy of both conditions, diagnosed by ultrasonography and CT angiography. A 56-year-old man with abrupt abdominal pain and hypovolemic shock was diagnosed initially with ruptured MCA aneurysm by color Doppler ultrasonography. Computed tomography and angiography confirmed MCA aneurysm and showed that it was arising from the false lumen of an SMA dissection and was probably associated with segmental arterial mediolysis. The MCA aneurysm was treated successfully by transcatheter coil embolization, and the SMA dissection was treated conservatively.

  16. Usefulness of tissue doppler and color M-mode indexes of left ventricular diastolic function in predicting outcomes in systolic left ventricular heart failure (from the ADEPT study).

    PubMed

    Troughton, Richard W; Prior, David L; Frampton, Christopher M; Nash, Patrick J; Pereira, Jeremy J; Martin, Maureen; Fogarty, Annette; Morehead, Annitta J; Starling, Randall C; Young, James B; Thomas, James D; Lauer, Michael S; Klein, Allan L

    2005-07-15

    The prognostic values of tissue Doppler imaging and color M-mode diastolic indexes were studied in 225 patients who had symptomatic systolic heart failure in the ADEPT study. The primary end point of death, transplantation, or hospitalization due to heart failure occurred in 65 patients and was independently predicted by shorter deceleration time, lower ratio of pulmonary vein systolic to diastolic velocity, and increasing levels of the ratios of early transmitral velocity to early annular velocity or velocity of propagation. For the ratio of early transmitral velocity to early annular velocity, this prediction was additive to deceleration time. Newer diastolic indexes provide an independent prediction of clinical outcomes.

  17. Serial color Doppler flow of uterine vasculature combined with serum beta-hCG measurements for improved monitoring of patients with gestational trophoblastic disease. A preliminary report.

    PubMed

    Maymon, R; Schneider, D; Shulman, A; Bukowsky, I; Weinraub, Z

    1996-01-01

    Weekly serum beta-hCG measurements and transvaginal ultrasound scans coupled with color Doppler flow were performed on 8 patients with hydatidiform mole. Two patients later developed persistent trophoblastic disease, necessitating chemotherapy. The correlation coefficients between Doppler flow indices, systolic-diastolic (S/D) ratio and pulsatility index (PI) with log beta-hCG were -0.96 and -0.97, respectively. The weekly S/D and PI indices were plotted on an individual curve. Only the 2 patients who developed persistent gestational trophoblastic disease had PI index levels of < or = 1.5 as early as 2 weeks after molar evacuation. At that stage their serum beta-hCG levels were not different from some of the other patients. In this preliminary report, the regression of the disease could be reliably assessed by observing the changes in low resistance flow which paralleled the gradual decrements in serial beta-hCG levels. Thus, the contribution of this noninvasive imaging technique encourages the authors to further investigate Doppler flow monitoring among a larger sample of patients suffering from various gestational trophoblastic diseases.

  18. Medial tibial pain: a dynamic contrast-enhanced MRI study.

    PubMed

    Mattila, K T; Komu, M E; Dahlström, S; Koskinen, S K; Heikkilä, J

    1999-09-01

    The purpose of this study was to compare the sensitivity of different magnetic resonance imaging (MRI) sequences to depict periosteal edema in patients with medial tibial pain. Additionally, we evaluated the ability of dynamic contrast-enhanced imaging (DCES) to depict possible temporal alterations in muscular perfusion within compartments of the leg. Fifteen patients with medial tibial pain were examined with MRI. T1-, T2-weighted, proton density axial images and dynamic and static phase post-contrast images were compared in ability to depict periosteal edema. STIR was used in seven cases to depict bone marrow edema. Images were analyzed to detect signs of compartment edema. Region-of-interest measurements in compartments were performed during DCES and compared with controls. In detecting periosteal edema, post-contrast T1-weighted images were better than spin echo T2-weighted and proton density images or STIR images, but STIR depicted the bone marrow edema best. DCES best demonstrated the gradually enhancing periostitis. Four subjects with severe periosteal edema had visually detectable pathologic enhancement during DCES in the deep posterior compartment of the leg. Percentage enhancement in the deep posterior compartment of the leg was greater in patients than in controls. The fast enhancement phase in the deep posterior compartment began slightly slower in patients than in controls, but it continued longer. We believe that periosteal edema in bone stress reaction can cause impairment of venous flow in the deep posterior compartment. MRI can depict both these conditions. In patients with medial tibial pain, MR imaging protocol should include axial STIR images (to depict bone pathology) with T1-weighted axial pre and post-contrast images, and dynamic contrast enhanced imaging to show periosteal edema and abnormal contrast enhancement within a compartment.

  19. Using Dynamic Contrast Enhanced MRI to Quantitatively Characterize Maternal Vascular Organization in the Primate Placenta

    PubMed Central

    Frias, A.E.; Schabel, M.C.; Roberts, V.H.J.; Tudorica, A.; Grigsby, P.L.; Oh, K.Y.; Kroenke, C. D.

    2015-01-01

    Purpose The maternal microvasculature of the primate placenta is organized into 10-20 perfusion domains that are functionally optimized to facilitate nutrient exchange to support fetal growth. This study describes a dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) method for identifying vascular domains, and quantifying maternal blood flow in them. Methods A rhesus macaque on the 133rd day of pregnancy (G133, term=165 days) underwent Doppler ultrasound (US) procedures, DCE-MRI, and Cesarean-section delivery. Serial T1-weighted images acquired throughout intravenous injection of a contrast reagent (CR) bolus were analyzed to obtain CR arrival time maps of the placenta. Results Watershed segmentation of the arrival time map identified 16 perfusion domains. The number and location of these domains corresponded to anatomical cotyledonary units observed following delivery. Analysis of the CR wave front through each perfusion domain enabled determination of volumetric flow, which ranged from 9.03 to 44.9 mL/sec (25.2 ± 10.3 mL/sec). These estimates are supported by Doppler US results. Conclusions The DCE-MRI analysis described here provides quantitative estimates of the number of maternal perfusion domains in a primate placenta, and estimates flow within each domain. Anticipated extensions of this technique are to the study placental function in nonhuman primate models of obstetric complications. PMID:24753177

  20. Role of intraoral color Doppler sonography in predicting delayed cervical lymph node metastasis in patients with early-stage tongue cancer: a pilot study.

    PubMed

    Ariji, Yoshiko; Goto, Mitsuo; Fukano, Hideo; Sugita, Yoshihiko; Izumi, Masahiro; Ariji, Eiichiro

    2015-02-01

    To clarify the intraoral color Doppler sonographic features of tongue cancer in relation to cervical lymph node metastasis. Thirty-one patients (24 men and 7 women; 32-87 years old; median 60.6 years) with T1-2 N0 squamous cell carcinoma of the tongue were enrolled. Preoperative clinical information and sonographic findings were collected. Patients were followed up for 2 years or more, and the presence of delayed lymph node metastasis was investigated. Significant clinical and sonographic factors were evaluated in relation to lymph node metastasis. Significant differences in maximum and minimum tumor size, clinical type, tumor depth and thickness, shape of the invading front of the tumor, vascular index (VI) of the tumor area, and asymmetry of the VI of the deep lingual artery were observed between patients with cervical lymph node metastasis and those without. The areas under the curve (AUCs) of tumor thickness and the VI of the tumor area were 0.861 and 0.909, respectively, on receiver operating characteristic (ROC) curve analysis for predicting lymph node metastasis. The AUC for the VI showed a slightly higher value, although the difference was not significant (P = .532). Intraoral color Doppler sonography is recommended, as it may identify predictive factors of cervical lymph node metastasis. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. How to Develop a Contrast-Enhanced Ultrasound Program.

    PubMed

    Barr, Richard G

    2017-02-02

    With the recent Food and Drug Administration approval of Lumason (sulfur hexafluoride lipid-type A microsphere, Bracco Diagnostics Inc, Monroe Township, NJ) for contrast-enhanced ultrasound (CEUS) to characterize focal liver lesions in both adult and pediatric patients, widespread use of CEUS is expected in the United States. This paper provides guidance in setting up a CEUS program, and reviews the practical details that will need to be instituted in a standard ultrasound department to provide both safe and efficient use of CEUS. A review of the indications, contraindications, adverse events, instructions for performing the exam, and image interpretation are discussed.

  2. Direct measurement of proximal isovelocity surface area by single-beat three-dimensional color Doppler echocardiography in mitral regurgitation: a validation study.

    PubMed

    de Agustín, Jose Alberto; Marcos-Alberca, Pedro; Fernandez-Golfin, Covadonga; Gonçalves, Alexandra; Feltes, Gisela; Nuñez-Gil, Ivan Javier; Almeria, Carlos; Rodrigo, Jose Luis; Perez de Isla, Leopoldo; Macaya, Carlos; Zamorano, Jose

    2012-08-01

    The two-dimensional (2D) proximal isovelocity surface area (PISA) method has some technical limitations, mainly the geometric assumptions of PISA shape required to calculate effective regurgitant orifice area (EROA). Recently developed single-beat, real-time three-dimensional (3D) color Doppler imaging allows direct measurement of PISA without geometric assumptions. The aim of this study was to validate this novel method in patients with chronic mitral regurgitation (MR). Thirty-three patients were included, 25 (75.7%) with degenerative MR and eight (24.2%) with functional MR. EROA and regurgitant volume were assessed using transthoracic 2D and 3D PISA methods. The quantitative Doppler method and 3D transesophageal echocardiographic planimetry of EROA were used as reference methods. Both EROA and regurgitant volume assessed using the 3D PISA method had better correlations with the reference methods than conventional 2D PISA. A consistent significant underestimation of EROA and regurgitant volume using 2D PISA was observed, particularly in the assessment of eccentric jets. On the basis of 3D transesophageal echocardiographic planimetry of EROA, 14 patients had severe MR (EROA ≥ 0.4 cm(2)). Of these 14 patients, 42.8% (6 of 14) were underestimated as having nonsevere MR (EROA ≤ 0.4 cm(2)) by the 2D PISA method. In contrast, the 3D PISA method had 92.9% (13 of 14) agreement with 3D transesophageal planimetry in classifying severe MR. Good intraobserver and interobserver agreement for 3D PISA measurements was observed, with intraclass correlation coefficients of 0.96 and 0.92, respectively. Direct measurement of PISA without geometric assumptions using single-beat, real-time 3D color Doppler echocardiography is feasible in the clinical setting. MR quantification using this methodology is more accurate than the conventional 2D PISA method. Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

  3. Color Doppler flow imaging for the early detection of nonpregnant cattle at 20 days after timed artificial insemination.

    PubMed

    Siqueira, L G B; Areas, V S; Ghetti, A M; Fonseca, J F; Palhao, M P; Fernandes, C A C; Viana, J H M

    2013-10-01

    The objective was to determine the accuracy of a pregnancy test for predicting nonpregnant cattle based on the evaluation of corpus luteum (CL) blood flow at 20 d (CLBF-d20) after timed artificial insemination (TAI). Crossbred Holstein-Gir dairy heifers (n=209) and lactating cows (n=317) were synchronized for TAI using the following protocol: intravaginal implant (1.0 g of progesterone) and 2mg of estradiol benzoate i.m. on d -10, implant removal and 0.526 mg of sodium cloprostenol i.m. on d -2, 1mg of estradiol benzoate i.m. on d -1, and TAI on d 0. On d 20, animals underwent grayscale ultrasonography (US) to locate the CL and color flow Doppler to evaluate CLBF-d20 using a portable ultrasound equipped with a 7.5-MHz rectal transducer. Based only on a visual, subjective CLBF evaluation, the animals were classified as pregnant or not pregnant. On d 30 to 35, blinded from results of the previous diagnosis, the same operator performed a final pregnancy diagnosis using US to visualize the fetal heartbeat (gold standard; US-d30). A second evaluator also analyzed the CLBF-d20 in the same animals by watching 7-s recorded videos. Blood samples were collected from a subset of 171 females to determine, by RIA, plasma progesterone (P4) concentrations, which indicate CL function. The final pregnancy outcome (US-d30) was retrospectively compared with the CLBF-d20 diagnoses and then classified either as correct or incorrect. The number of true positive, true negative, false positive, and false negative decisions were inserted into a 2 × 2 decision matrix. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CLBF-d20 test were calculated using specific equations. Binomial variables (pregnancy rate and proportions) were analyzed using Fisher's exact test for the effect of parity and to compare between evaluators and tests (CLBF-d20 vs. plasma P₄). The kappa values were calculated to quantify the agreement between CLBF-d20 and

  4. Fuzzy pulmonary vessel segmentation in contrast enhanced CT data

    NASA Astrophysics Data System (ADS)

    Kaftan, Jens N.; Kiraly, Atilla P.; Bakai, Annemarie; Das, Marco; Novak, Carol L.; Aach, Til

    2008-03-01

    Pulmonary vascular tree segmentation has numerous applications in medical imaging and computer-aided diagnosis (CAD), including detection and visualization of pulmonary emboli (PE), improved lung nodule detection, and quantitative vessel analysis. We present a novel approach to pulmonary vessel segmentation based on a fuzzy segmentation concept, combining the strengths of both threshold and seed point based methods. The lungs of the original image are first segmented and a threshold-based approach identifies core vessel components with a high specificity. These components are then used to automatically identify reliable seed points for a fuzzy seed point based segmentation method, namely fuzzy connectedness. The output of the method consists of the probability of each voxel belonging to the vascular tree. Hence, our method provides the possibility to adjust the sensitivity/specificity of the segmentation result a posteriori according to application-specific requirements, through definition of a minimum vessel-probability required to classify a voxel as belonging to the vascular tree. The method has been evaluated on contrast-enhanced thoracic CT scans from clinical PE cases and demonstrates overall promising results. For quantitative validation we compare the segmentation results to randomly selected, semi-automatically segmented sub-volumes and present the resulting receiver operating characteristic (ROC) curves. Although we focus on contrast enhanced chest CT data, the method can be generalized to other regions of the body as well as to different imaging modalities.

  5. Contrast enhanced imaging with a stationary digital breast tomosynthesis system

    NASA Astrophysics Data System (ADS)

    Puett, Connor; Calliste, Jabari; Wu, Gongting; Inscoe, Christina R.; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2017-03-01

    Digital breast tomosynthesis (DBT) captures some depth information and thereby improves the conspicuity of breast lesions, compared to standard mammography. Using contrast during DBT may also help distinguish malignant from benign sites. However, adequate visualization of the low iodine signal requires a subtraction step to remove background signal and increase lesion contrast. Additionally, attention to factors that limit contrast, including scatter, noise, and artifact, are important during the image acquisition and post-acquisition processing steps. Stationary DBT (sDBT) is an emerging technology that offers a higher spatial and temporal resolution than conventional DBT. This phantom-based study explored contrast-enhanced sDBT (CE sDBT) across a range of clinically-appropriate iodine concentrations, lesion sizes, and breast thicknesses. The protocol included an effective scatter correction method and an iterative reconstruction technique that is unique to the sDBT system. The study demonstrated the ability of this CE sDBT system to collect projection images adequate for both temporal subtraction (TS) and dual-energy subtraction (DES). Additionally, the reconstruction approach preserved the improved contrast-to-noise ratio (CNR) achieved in the subtraction step. Finally, scatter correction increased the iodine signal and CNR of iodine-containing regions in projection views and reconstructed image slices during both TS and DES. These findings support the ongoing study of sDBT as a potentially useful tool for contrast-enhanced breast imaging and also highlight the significant effect that scatter has on image quality during DBT.

  6. Contrast-enhanced magnetic resonance imaging of hypoperfused myocardium.

    PubMed

    Schaefer, S; Lange, R A; Gutekunst, D P; Parkey, R W; Willerson, J T; Peshock, R M

    1991-06-01

    Contrast-enhanced magnetic resonance (MR) imaging can define myocardial perfusion defects due to acute coronary occlusion. However, since most clinically important diagnostic examinations involve coronary arteries with subtotal stenoses, we investigated the ability of MR imaging with a manganese contrast agent to detect perfusion abnormalities in a canine model of partial coronary artery stenosis. The contrast agent was administered after the creation of a partial coronary artery stenosis with the addition of the coronary vasodilator dipyridamole in six of 12 animals. The hearts were imaged ex situ using gradient reversal and spin-echo sequences, and images were analyzed to determine differences in signal intensity between hypoperfused and normally perfused myocardium. Comparison of MR images with regional blood flow and thallium-201 measurements showed good concordance of hypoperfused segments in those animals given dipyridamole, with 75% of the abnormal segments correctly identified. In those animals not given dipyridamole, 48% of segments were correctly identified. Thus, ex vivo MR imaging with a paramagnetic contrast enhancement can be used to detect acute regional myocardial perfusion abnormalities due to severe partial coronary artery stenoses.

  7. Focal Liver Lesions: Real-time 3-Dimensional Contrast-Enhanced Ultrasonography Compared With 2-Dimensional Contrast-Enhanced Ultrasonography and Magnetic Resonance Imaging.

    PubMed

    Lee, Jung-Chieh; Yan, Kun; Lee, San-Kan; Yang, Wei; Chen, Min-Hua

    2017-06-24

    This study sought to evaluate the application of real-time 3-dimensional (3D) contrast-enhanced ultrasonography (US) to diagnose focal liver lesions and to compare these results with those from 2-dimensional (2D) contrast-enhanced US and contrast-enhanced magnetic resonance imaging (MRI). Patients with focal liver lesions were examined by 2D contrast-enhanced US, 3D contrast-enhanced US, and contrast-enhanced MRI for lesion characterization, and biopsies and comprehensive clinical diagnoses served as reference standards. The sensitivity, specificity, area under the receiver operating characteristic curve, and intermodality agreement were assessed. The number of contrast agent injections and lesions observed per injection were calculated for 3D and 2D contrast-enhanced US. The number and display quality of the feeding arteries observed with 3D and 2D contrast-enhanced US were assessed. A total of 117 patients with 151 focal liver lesions were enrolled, including 67 cases of hepatocellular carcinoma, 51 cases of liver metastasis, and 33 cases of benign liver lesions. No significant differences were found among the modalities. The sensitivity values for 3D contrast-enhanced US, 2D contrast-enhanced US, and contrast-enhanced MRI were 96%, 95%, and 93%, respectively; the specificity values were 87%, 84%, and 89%; and the area under the receiver operating characteristic curve values were 0.92, 0.90, and 0.92. The intermodality agreement was excellent (κ > 0.77). Fewer contrast agent injections were needed, and more lesions and feeding arteries were more clearly displayed on 3D than 2D contrast-enhanced US (P < .001). Real-time 3D contrast-enhanced US is useful for diagnosing focal liver lesions and for observing feeding arteries with fewer contrast agent injections. © 2017 by the American Institute of Ultrasound in Medicine.

  8. [Duplex ultrasound detection of type II endoleaks by after endovascular aneurysm repair: interest of contrast enhancement].

    PubMed

    Costa, P; Bureau Du Colombier, P; Lermusiaux, P

    2013-12-01

    Type II endoleaks (EFII) are related to retrograde flow via aorta tributaries. They are the most frequent complication after endovascular aneurysm repair (EVAR). We hypothesized that the use of contrast-enhanced ultrasound (CEUS) by an experienced vascular physician could increase the sensitivity of detecting EFII compared with computed tomography angiography (CTA) taken as the gold standard. From November 2010 to February 2013, patients with EVAR were included prospectively. All patients had a color duplex ultrasound (CDU), CEUS and CTA. Sensitivity, specificity and kappa's coefficient were determined to estimate the performance of CDU and CEUS to assess EFII compared with CTA. Sixty CDU and 60 CEUS explorations were compared to 60 CTA explorations. Nineteen type EFII were detected by CTA, 14 by CDU and 15 by CEUS. CDU sensitivity was 74% (κ=0.75), and CEUS sensitivity was 78% (κ=0.8). Both tests exhibited 97% specificity. There was good agreement between CDU results (κ=0.75) and CEUS results (κ=0.8) compared with CTA. There was very good agreement between CDU and CEUS results for detection of EFII (κ=0.93). There was no statistically significant difference between the sensitivity of CDU and CEUS (P=0.32). Our results suggest that contrast enhancement does not increase yield for ultrasound detection of type II endoleaks when performed by an experienced vascular physician. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  9. Validation of color Doppler ultrasonography for evaluating the uterine blood flow and perfusion during late normal pregnancy and uterine torsion in buffaloes.

    PubMed

    Hussein, Hassan A

    2013-04-15

    The aim of this study was to verify the efficacy of color Doppler ultrasonography for diagnosis of degree and duration of uterine torsion in buffaloes. In Assiut province/Upper Egypt, 65 buffaloes (37 with uterine torsion, 28 with normal late pregnancy) were examined clinically and using Doppler ultrasonography. The Doppler indices including resistance index (RI), pulsatility index (PI), time-averaged maximum velocity (TAMV), and blood flow volume (BFV) in the arteries ipsilateral to the uterine torsion (IPUT) and in arteries contralateral to the uterine torsion (COUT) were recorded. Methods of correction were documented along with dam and calf survival. Torsion was recorded postcervically with vaginal involvement in 35/37 (94.6%) of the cases. The degrees of uterine torsion were light and high in 9/37 (24.3%) and 28/37 (75.7%) of the cases, respectively (P = 0.001). Right uterine torsion was present in 36/37 (97.3%) of the cases (P = 0.0001). Pulsatility index, RI, TAMV, and BFV in IPUT and COUT did not differ significantly (P > 0.05) in normal late pregnancy. The PI and RI in IPUT were significantly higher (P < 0.01) than in COUT, and the TAMV and BFV in IPUT were less (P < 0.001) than that in COUT in uterine torsion. The PI and RI of torsion cases in IPUT were higher (P < 0.001) than that in normal pregnancy. Time-averaged maximum velocity and BFV in torsion cases were lower (P < 0.01) than that of normal pregnancy in IPUT. There was approximately 50% of RI and PI higher than in light degree uterine torsion in IPUT (P < 0.001). Consequently, TAMV and BFV were greatly lower (P < 0.0001) than that in light degree in IPUT. Pulsatility index and RI were positively correlated (r = 0.856; P < 0.001) with the duration and degree of the uterine torsion, and TAMV and BFV were negatively correlated (r = -0.763; P < 0.001). In all cases of uterine torsion the uterine flow velocity waveform showed high systolic flow and absence of early diastolic flow and poor uterine and

  10. Porcine Ex Vivo Liver Phantom for Dynamic Contrast-Enhanced Computed Tomography: Development and Initial Results

    PubMed Central

    Thompson, Scott M.; Giraldo, Juan C. Ramirez; Knudsen, Bruce; Grande, Joseph P.; Christner, Jodie A.; Xu, Man; Woodrum, David A.; McCollough, Cynthia H.; Callstrom, Matthew R.

    2011-01-01

    Objectives To demonstrate the feasibility of developing a fixed, dual-input, biological liver phantom for dynamic contrast-enhanced computed tomography (CT) imaging and to report initial results of use of the phantom for quantitative CT perfusion imaging. Materials and Methods Porcine livers were obtained from completed surgical studies and perfused with saline and fixative. The phantom was placed in a body-shaped, CT-compatible acrylic container and connected to a perfusion circuit fitted with a contrast injection port. Flow-controlled contrast-enhanced imaging experiments were performed using a 128-slice and 64 slice, dual-source multidetector CT scanners. CT angiography protocols were employed to obtain portal venous and hepatic arterial vascular enhancement, reproduced over a period of four to six months. CT perfusion protocols were employed at different input flow rates to correlate input flow with calculated tissue perfusion, to test reproducibility and demonstrate the feasibility of simultaneous dual input liver perfusion. Histologic analysis of the liver phantom was also performed. Results CT angiogram 3D reconstructions demonstrated homogenous tertiary and quaternary branching of the portal venous system out to the periphery of all lobes of the liver as well as enhancement of the hepatic arterial system to all lobes of the liver and gallbladder throughout the study period. For perfusion CT, the correlation between the calculated mean tissue perfusion in a volume of interest and input pump flow rate was excellent (R2 = 0.996) and color blood flow maps demonstrated variations in regional perfusion in a narrow range. Repeat perfusion CT experiments demonstrated reproducible time-attenuation curves and dual-input perfusion CT experiments demonstrated that simultaneous dual input liver perfusion is feasible. Histologic analysis demonstrated that the hepatic microvasculature and architecture appeared intact and well preserved at the completion of four to six

  11. Contrast-enhanced ultrasound (CEUS) in nephrology: Has the time come for its widespread use?

    PubMed

    Granata, Antonio; Zanoli, Luca; Insalaco, Monica; Valentino, Massimo; Pavlica, Pietro; Di Nicolò, Pier Paolo; Scuderi, Mario; Fiorini, Fulvio; Fatuzzo, Pasquale; Bertolotto, Michele

    2015-08-01

    Grey-scale ultrasound has an important diagnostic role in nephrology. The absence of ionizing radiations and nephrotoxicity, rapidity of execution, excellent repeatability, the possibility to perform the test at the patient's bed and the low cost represent important advantages of this technique. Paired with real-time sonography and colour-power-Doppler contrast-enhanced ultrasound (CEUS) reduces the diagnostic gap with computed tomography (CT) and magnetic resonance (MR) and represents a major step in the evolution of clinical ultrasound. Although there are several situations in which contrast-enhanced CT and MR are indicated (i.e. evaluation of cystic or ischemic lesions, traumatisms and ablative therapies of the native and transplanted kidney), the use of CT contrast media presents a high risk of contrast-induced nephropathy (i.e. in elderly people, subjects with comorbidities and those with renal dysfunction), while gadolinium-based RM contrast agents are contraindicated for the risk of nephrogenic systemic fibrosis (i.e. in patients with severe renal dysfunction). In these situations, CEUS may be a viable alternative, however, as any technique associated with the infusion of pharmacological substances, the potential advantages and risks of CEUS should be critically evaluated. In this regard, the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) has published the guidelines for the use of CEUS for the kidney imaging and the International Contrast Ultrasound Society (ICUS) has been recently founded. The aim of this review is to offer an updated overview of the potential applications of CEUS in nephrology, reporting some indications and possible risks associated to its use.

  12. [Management of salivary gland diseases with contrast-enhanced ultrasound].

    PubMed

    Zengel, P; Schrötzlmair, F; Kramer, M; Paprottka, P; Clevert, D-A

    2011-06-01

    Obstructive diseases of the salivary glands are a common problem in otorhinolaryngology. They are mostly due to sialolithiasis followed by duct stenosis and other rarer causes. Several diagnostic modalities exist which allow classification of the disease; however, in 5-10% of all cases ultrasound and conventional radiological imaging do not provide a clear diagnosis. Ultrasound examination with contrast material injected into the duct (IA-CEUS, intraductal administered contrast-enhanced ultrasound) enables improved evaluation of obstructive diseases of the salivary glands and at the same time an evaluation of the parenchyma of the glands is possible. As a complementary method to conventional investigation techniques IA-CEUS is an economic and rapid method with low side-effects which improves the diagnostic assessment of ultrasound and results in a better treatment for patients.

  13. Contrast enhancing solution for use in confocal microscopy

    DOEpatents

    Tannous, Zeina; Torres, Abel; Gonzalez, Salvador

    2006-10-31

    A method of optically detecting a tumor during surgery. The method includes imaging at least one test point defined on the tumor using a first optical imaging system to provide a first tumor image. The method further includes excising a first predetermined layer of the tumor for forming an in-vivo defect area. A predetermined contrast enhancing solution is disposed on the in-vivo defect area, which is adapted to interact with at least one cell anomaly, such as basal cell carcinoma, located on the in-vivo defect area for optically enhancing the cell anomaly. Thereafter the defect area can be optically imaged to provide a clear and bright representation of the cell anomaly to aid a surgeon while surgically removing the cell anomaly.

  14. Contrast-enhanced imaging of cerebral vasculature with laser speckle

    NASA Astrophysics Data System (ADS)

    Murari, K.; Li, N.; Rege, A.; Jia, X.; All, A.; Thakor, N.

    2007-08-01

    High-resolution cerebral vasculature imaging has applications ranging from intraoperative procedures to basic neuroscience research. Laser speckle, with spatial contrast processing, has recently been used to map cerebral blood flow. We present an application of the technique using temporal contrast processing to image cerebral vascular structures with a field of view a few millimeters across and approximately 20 μm resolution through a thinned skull. We validate the images using fluorescent imaging and demonstrate a factor of 2-4 enhancement in contrast-to-noise ratios over reflectance imaging using white or spectrally filtered green light. The contrast enhancement enables the perception of approximately 10%-30% more vascular structures without the introduction of any contrast agent.

  15. Contrast agents in dynamic contrast-enhanced magnetic resonance imaging

    PubMed Central

    Yan, Yuling; Sun, Xilin; Shen, Baozhong

    2017-01-01

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a noninvasive method to assess angiogenesis, which is widely used in clinical applications including diagnosis, monitoring therapy response and prognosis estimation in cancer patients. Contrast agents play a crucial role in DCE-MRI and should be carefully selected in order to improve accuracy in DCE-MRI examination. Over the past decades, there was much progress in the development of optimal contrast agents in DCE-MRI. In this review, we describe the recent research advances in this field and discuss properties of contrast agents, as well as their advantages and disadvantages. Finally, we discuss the research perspectives for improving this promising imaging method. PMID:28415647

  16. Contrast-Enhanced Ultrasonography in Crohn's Disease Diagnostics.

    PubMed

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Liebert, Ariel; Kłopocka, Maria; Serafin, Zbigniew

    2015-06-01

    The chronic nature of Crohn's disease (CD) implicates necessity of multiple control assessments throughout patient's life. It is accepted that in patients with CD requiring disease monitoring, magnetic resonance enterography (MRE) and computed tomography enterography (CTE) are--apart from endoscopy--imaging studies of first choice. In practice, diagnostic imaging of patients with CD is troublesome, since MRE is an expensive and complicated study, and CTE exposes patients to high doses of ionizing radiation. Therefore, there is a need for new, both non-invasive and effective, methods of imaging in CD. Contrast-Enhanced Ultrasonography (CEUS) is a relatively new method using gas-filled microbubbles serving as contrast agent. It allows for detailed assessment of blood perfusion within intestine wall and peri-intestinal tissues, which enables detection and monitoring of inflammation and its qualitative assessment. The purpose of this paper is to describe CEUS examination technique and its clinical applications in patients with Crohn's disease.

  17. Microvascular contrast enhancement in optical coherence tomography using microbubbles

    NASA Astrophysics Data System (ADS)

    Assadi, Homa; Demidov, Valentin; Karshafian, Raffi; Douplik, Alexandre; Vitkin, I. Alex

    2016-07-01

    Gas microbubbles (MBs) are investigated as intravascular optical coherence tomography (OCT) contrast agents. Agar + intralipid scattering tissue phantoms with two embedded microtubes were fabricated to model vascular blood flow. One was filled with human blood, and the other with a mixture of human blood + MB. Swept-source structural and speckle variance (sv) OCT images, as well as speckle decorrelation times, were evaluated under both no-flow and varying flow conditions. Faster decorrelation times and higher structural and svOCT image contrasts were detected in the presence of MB in all experiments. The effects were largest in the svOCT imaging mode, and uniformly diminished with increasing flow velocity. These findings suggest the feasibility of utilizing MB for tissue hemodynamic investigations and for microvasculature contrast enhancement in OCT angiography.

  18. When to Order a Contrast-Enhanced CT.

    PubMed

    Rawson, James V; Pelletier, Allen L

    2013-09-01

    Family physicians often must determine the most appropriate diagnostic tests to order for their patients. It is essential to know the types of contrast agents, their risks, contraindications, and common clinical scenarios in which contrast-enhanced computed tomography is appropriate. Many types of contrast agents can be used in computed tomography: oral, intravenous, rectal, and intrathecal. The choice of contrast agent depends on route of administration, desired tissue differentiation, and suspected diagnosis. Possible contraindications for using intravenous contrast agents during computed tomography include a history of reactions to contrast agents, pregnancy, radioactive iodine treatment for thyroid disease, metformin use, and chronic or acutely worsening renal disease. The American College of Radiology Appropriateness Criteria is a useful online resource. Clear communication between the physician and radiologist is essential for obtaining the most appropriate study at the lowest cost and risk to the patient.

  19. Design of a clinical vein contrast enhancing projector

    NASA Astrophysics Data System (ADS)

    Zeman, Herbert D.; Lovhoiden, Gunnar; Deshmukh, Harshal

    2001-06-01

    A clinical study has been initiated to compare an experimental IR device, the Vein Contrast Enhancer (VCE), with standard techniques for finding veins for venipuncture. The aims of this proposal are (1) to evaluate the performance of the VCE in a clinical setting, specifically by comparing its sensitivity of detection with existing vein-finding techniques used by experienced nurses or phlebotomists, (2) to study its usefulness in subjects who are obese, who have difficult venous access or thrombosed veins, or whose veins are not visible or difficult to palpate, and (3) to show that it performs as well on subjects with darkly pigmented skin as on subjects with lightly pigmented skin. The VCE will first be studied in adult subjects, and then in pediatric subjects.

  20. Contrast enhanced ultrasound (CEUS) in blunt abdominal trauma.

    PubMed

    Cagini, Lucio; Gravante, Sabrina; Malaspina, Corrado Maria; Cesarano, Elviro; Giganti, Melchiorre; Rebonato, Alberto; Fonio, Paolo; Scialpi, Michele

    2013-07-15

    In the assessment of polytrauma patient, an accurate diagnostic study protocol with high sensitivity and specificity is necessary. Computed Tomography (CT) is the standard reference in the emergency for evaluating the patients with abdominal trauma. Ultrasonography (US) has a high sensitivity in detecting free fluid in the peritoneum, but it does not show as much sensitivity for traumatic parenchymal lesions. The use of Contrast-Enhanced Ultrasound (CEUS) improves the accuracy of the method in the diagnosis and assessment of the extent of parenchymal lesions. Although the CEUS is not feasible as a method of first level in the diagnosis and management of the polytrauma patient, it can be used in the follow-up of traumatic injuries of abdominal parenchymal organs (liver, spleen and kidneys), especially in young people or children.

  1. Contrast enhanced ultrasound (CEUS) in blunt abdominal trauma

    PubMed Central

    2013-01-01

    In the assessment of polytrauma patient, an accurate diagnostic study protocol with high sensitivity and specificity is necessary. Computed Tomography (CT) is the standard reference in the emergency for evaluating the patients with abdominal trauma. Ultrasonography (US) has a high sensitivity in detecting free fluid in the peritoneum, but it does not show as much sensitivity for traumatic parenchymal lesions. The use of Contrast-Enhanced Ultrasound (CEUS) improves the accuracy of the method in the diagnosis and assessment of the extent of parenchymal lesions. Although the CEUS is not feasible as a method of first level in the diagnosis and management of the polytrauma patient, it can be used in the follow-up of traumatic injuries of abdominal parenchymal organs (liver, spleen and kidneys), especially in young people or children. PMID:23902930

  2. Denoising in Contrast-Enhanced X-ray Images

    NASA Astrophysics Data System (ADS)

    Jeon, Gwanggil

    2016-12-01

    In this paper, we propose a denoising and contrast-enhancement method for medical images. The main purpose of medical image improvement is to transform lower contrast data into higher contrast, and to reduce high noise levels. To meet this goal, we propose a noise-level estimation method, whereby the noise level is estimated by computing the standard deviation and variance in a local block. The obtained noise level is then used as an input parameter for the block-matching and 3D filtering (BM3D) algorithm, and the denoising process is then performed. Noise-level estimation step is important because the BM3D algorithm does not perform well without correct noise-level information. Simulation results confirm that the proposed method outperforms other benchmarks with respect to both their objective and visual performances.

  3. Role of contrast-enhanced endoscopic ultrasound in lymph nodes

    PubMed Central

    Hocke, Michael; Ignee, Andre; Dietrich, Christoph

    2017-01-01

    Diagnosing unclear lymph node (LN) enlargements in the mediastinum and abdomen is the most important indication of endoscopic ultrasound (EUS)-fine needle aspiration (FNA) after the diagnosis and treatment of pancreatic diseases. Investigating LNs in these areas can happen in different clinical settings. Mostly, it is the first modality in general LN diseases without any peripheral LN enlargements. On the other hand, it can be the question of LN involvement in a known or suspected primary tumor. Due to EUS-FNA cytology, those questions can be answered highly, accurately. However, a primary discrimination of LNs might be helpful to increase the diagnostic value of the FNA cytology, especially in cases with multiple LN enlargements and hard to reach enlarged LNs for example by vessel interposition. Because of the unreliability of B-mode criteria, further diagnostic improvements such as elastography and contrast-enhanced EUS are investigated to increase the accuracy of the initial diagnosis. PMID:28218194

  4. Image contrast enhancement based on a local standard deviation model

    SciTech Connect

    Chang, Dah-Chung; Wu, Wen-Rong

    1996-12-31

    The adaptive contrast enhancement (ACE) algorithm is a widely used image enhancement method, which needs a contrast gain to adjust high frequency components of an image. In the literature, the gain is usually inversely proportional to the local standard deviation (LSD) or is a constant. But these cause two problems in practical applications, i.e., noise overenhancement and ringing artifact. In this paper a new gain is developed based on Hunt`s Gaussian image model to prevent the two defects. The new gain is a nonlinear function of LSD and has the desired characteristic emphasizing the LSD regions in which details are concentrated. We have applied the new ACE algorithm to chest x-ray images and the simulations show the effectiveness of the proposed algorithm.

  5. Contrast enhancement in natural scenes using multiband polarization methods

    NASA Astrophysics Data System (ADS)

    Duggin, Michael J.; Kinn, Gerald J.; Bohling, Edward H.

    1997-10-01

    Relatively little work has been performed to investigate the potential of polarization techniques to provide contrast enhancement in natural scenes. Largely, this is because film is less accurate radiometrically than digital CCD FPA sensing devices. Such enhancement is additional to that provided by between-band differences for multiband data. Recently, Kodak has developed several digital imaging cameras which were intended for professional photographers. The variant we used obtained images in the green, red and near infrared, simulating CIR film. However, the application of linear drivers to rad the data from the camera into the computer has resulted in a device which can be used as a multiband imaging polarimeter. Here we examine the potential of digital image acquisition as a potential quantitative method to obtain new information additional to that obtained by multiband or even hyperspectral imaging methods. We present an example of an active on-going research program.

  6. Contrast-enhanced ultrasonography to diagnose complicated acute cholecystitis.

    PubMed

    Sagrini, Elisabetta; Pecorelli, Anna; Pettinari, Irene; Cucchetti, Alessandro; Stefanini, Federico; Bolondi, Luigi; Piscaglia, Fabio

    2016-02-01

    Gangrenous cholecystitis and perforation are severe complications of acute cholecystitis, which have a challenging preoperative diagnosis. Early identification allows better surgical management. Contrast-enhanced computed tomography (ceCT) is the current diagnostic gold standard. Contrast-enhanced ultrasonography (CEUS) is a promising tool for the diagnosis of gallbladder perforation, but data from the literature concerning efficacy are sparse. The aim of the study was to evaluate CEUS findings in pathologically proven complicated cholecystitis (gangrenous, perforated gallbladder, pericholecystic abscess). A total of 8 patients submitted to preoperative CEUS, and with subsequent proven acute complicated cholecystitis at surgical inspection and pathological analysis, were retrospectively identified. The final diagnosis was gangrenous/phlegmonous cholecystitis (n. 2), phlegmonous/ulcerative changes plus pericholecystic abscess (n. 2), perforated plus pericholecystic abscess (n. 3), or perforated plus pericholecystic biliary collection (n. 1). Conventional US findings revealed irregularly thickened gallbladder walls in all 8 patients, with vaguely defined walls in 7 patients, four of whom also had striated wall thickening. CEUS revealed irregular enhancing gallbladder walls in all patients. A distinct wall defect was seen in six patients, confirmed as gangrenous/phlegmonous cholecystitis at pathology in all six, and in four as perforation at macroscopic surgical inspection. CEUS is a non-invasive easily repeatable technique that can be performed at the bedside, and is able to accurately diagnose complicated/perforated cholecystitis. Despite the limited sample size in the present case series, CEUS appears as a promising tool for the management of patients with the clinical possibility of having an acute complicated cholecystitis.

  7. Contrast-enhanced microwave detection and treatment of breast cancer

    NASA Astrophysics Data System (ADS)

    Gao, Fuqiang

    Contrast agents and heating agents have been proposed for microwave breast tumor imaging and treatment, respectively. The dielectric properties of the tumor are altered with contrast agents or heating agents that locally accumulate in the tumor. The resulting change in dielectric properties of the tumor has the potential to enhance the sensitivity of microwave imaging of breast tumors and increase the efficiency and selectivity of microwave thermal therapy of breast tumors. This dissertation addresses several key challenges in contrast-enhanced microwave imaging and treatment of breast tumors. Carbon nanotubes (CNTs) have been shown to enhance both the relative permittivity and effective conductivity of the host medium, and are promising as theranostic (integrated therapeutic and diagnostic) agents. Thus, our properties characterization work focuses on CNT dispersions. We performed in vitro microwave dielectric properties and heating response characterization of dispersions of CNTs treated by different functionalization methods and identified a CNT formulation that is very promising as a microwave theranostic agent. Stable dispersions of CNTs with concentrations up to 20 mg/ml are obtained with this formulation, and the enhanced microwave properties of these dispersions are extraordinary compared to the control. We also conducted in vivo dielectric properties characterization of mouse tumors with intra-tumoral injections of CNT dispersions and confirmed that the presence of CNTs increases the dielectric properties of the tumor. In parallel, we developed a contrast-enhanced microwave breast tumor imaging algorithm using sparse reconstruction methods. We demonstrated that this algorithm accurately localizes small tumors in 3D numerical breast phantoms. We also demonstrated the experimental feasibility of this method using physical breast phantoms. Lastly, we studied the sensitivity of the distorted Born iterative method (DBIM) to initial guesses and developed a

  8. Vascular applications of contrast-enhanced ultrasound imaging.

    PubMed

    Mehta, Kunal S; Lee, Jake J; Taha, Ashraf A; Avgerinos, Efthymios; Chaer, Rabih A

    2017-07-01

    Contrast-enhanced ultrasound (CEUS) imaging is a powerful noninvasive modality offering numerous potential diagnostic and therapeutic applications in vascular medicine. CEUS imaging uses microbubble contrast agents composed of an encapsulating shell surrounding a gaseous core. These microbubbles act as nearly perfect intravascular reflectors of ultrasound energy and may be used to enhance the overall contrast and quality of ultrasound images. The purpose of this narrative review is to survey the current literature regarding CEUS imaging and discuss its diagnostic and therapeutic roles in current vascular and selected nonvascular applications. The PubMed, MEDLINE, and Embase databases were searched until July 2016 using the PubMed and Ovid Web-based search engines. The search terms used included contrast-enhanced, microbubble, ultrasound, carotid, aneurysm, and arterial. The diagnostic and therapeutic utility of CEUS imaging has grown exponentially, particularly in the realms of extracranial carotid arterial disease, aortic disease, and peripheral arterial disease. Studies have demonstrated that CEUS imaging is diagnostically superior to conventional ultrasound imaging in identifying vessel irregularities and measuring neovascularization to assess plaque vulnerability and end-muscle perfusion. Groups have begun to use microbubbles as agents in therapeutic applications for targeted drug and gene therapy delivery as well as for the enhancement of sonothrombolysis. The emerging technology of microbubbles and CEUS imaging holds considerable promise for cardiovascular medicine and cancer therapy given its diagnostic and therapeutic utility. Overall, with proper training and credentialing of technicians, the clinical implications are innumerable as microbubble technology is rapidly bursting onto the scene of cardiovascular medicine. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  9. Contrast-enhanced ultrasound (CEUS) in blunt abdominal trauma

    PubMed Central

    Piccolo, Claudia Lucia; Galluzzo, Michele; Ianniello, Stefania; Sessa, Barbara; Trinci, Margherita

    2016-01-01

    Baseline ultrasound is essential in the early assessment of patients with a huge haemoperitoneum undergoing an immediate abdominal surgery; nevertheless, even with a highly experienced operator, it is not sufficient to exclude parenchymal injuries. More recently, a new ultrasound technique using second generation contrast agents, named contrast-enhanced ultrasound (CEUS) has been developed. This technique allows all the vascular phase to be performed in real time, increasing ultrasound capability to detect parenchymal injuries, enhancing some qualitative findings, such as lesion extension, margins and its relationship with capsule and vessels. CEUS has been demonstrated to be almost as sensitive as contrast-enhanced CT in the detection of traumatic injuries in patients with low-energy isolated abdominal trauma, with levels of sensitivity and specificity up to 95%. Several studies demonstrated its ability to detect lesions occurring in the liver, spleen, pancreas and kidneys and also to recognize active bleeding as hyperechoic bands appearing as round or oval spots of variable size. Its role seems to be really relevant in paediatric patients, thus avoiding a routine exposure to ionizing radiation. Nevertheless, CEUS is strongly operator dependent, and it has some limitations, such as the cost of contrast media, lack of panoramicity, the difficulty to explore some deep regions and the poor ability to detect injuries to the urinary tract. On the other hand, it is timesaving, and it has several advantages, such as its portability, the safety of contrast agent, the lack to ionizing radiation exposure and therefore its repeatability, which allows follow-up of those traumas managed conservatively, especially in cases of fertile females and paediatric patients. PMID:26607647

  10. Initial Clinical Experience with Contrast-Enhanced Digital Breast Tomosynthesis

    PubMed Central

    Chen, Sara C.; Carton, Ann-Katherine; Albert, Michael; Conant, Emily F.; Schnall, Mitchell D.; Maidment, Andrew D. A.

    2007-01-01

    RATIONALE and OBJECTIVES Contrast-enhanced digital mammography and digital breast tomosynthesis are 2 imaging techniques that attempt to increase malignant breast lesion conspicuity. The combination of these into a single technique, contrast-enhanced digital breast tomosynthesis (CE-DBT), could potentially integrate the strengths of both. The objectives of this study were to assess the clinical feasibility of CE-DBT as an adjunct to digital mammography, and to correlate lesion enhancement characteristics and morphology obtained with CE-DBT to digital mammography, ultrasound, and magnetic resonance (MR). MATERIALS and METHODS CE-DBT (GE Senographe 2000D, Milwaukee, WI) was performed as a pilot study in an ongoing NCI-funded grant (P01 CA85484) studying multimodality breast imaging. 13 patients with ACR BI-RADS category 4 or 5 breast lesions underwent imaging with digital mammography, ultrasound, MR, and CE-DBT. CE-DBT was performed at 45-49 kVp with a rhodium target and a 0.27 mm copper (Alfa Aesar, Ward Hill, MA) filter. Pre- and post-injection DBT image sets were acquired in the MLO projection with slight compression. Each image set consists of 9 images acquired over a 50° arc and was obtained with a mean glandular x-ray dose comparable to two conventional mammographic views. Between the pre- and post-contrast DBT image sets, a single bolus of iodinated contrast agent (1 ml/kg at 2 ml/s; Omnipaque-300, Amersham Health Inc., Princeton, NJ) was administered. Images were reconstructed using filtered-backprojection in 1 mm increments, and transmitted to a clinical PACS workstation. RESULTS Initial experience suggests that CE-DBT provides morphologic and vascular characteristics of breast lesions qualitatively concordant with that of digital mammography and MR. CONCLUSION As an adjunct to digital mammography, CE-DBT may be a potential alternative tool for breast lesion morphologic and vascular characterization. PMID:17236995

  11. Can Transcranial Color Doppler Spectral Signatures be a Novel Biomarker for Monitoring Cerebrovascular Autoregulation and Intracranial Pressure? A Speculative Synthesis

    PubMed Central

    Mangalore, Sandhya; Kotresh; Srinivasa, Rakshith; Hegde, Alangar Sathyaranjandas; Srinivasa, Rangashetty

    2017-01-01

    Background: Trans Cranial Colour Doppler (TCCD) has been extensively used in various neurological and neurosurgical conditions causing severe raise in the intracranial pressure (ICP). Material and Method: Our study explores the sequential evolution of TCCD flow pattern by correlating with pupillary reactivity, Glasgow coma scale (GCS), and imaging. Our cohort consisted of thirty patients with ten patients in each subgroup admitted to the neuro-Intensive Care Unit (NICU) for various neurological and neurosurgical causes. Middle cerebral artery was insonated through the transtemporal window at the time of admission to NICU. Doppler waveform and parameters such as peak systolic velocity, end-diastolic velocity, systolic by diastolic ratio, pulsatility index, and resistivity index were recorded. The clinical variables for evaluating the degree of raised ICP were the GCS and pupil size. Other systemic parameters such as mean arterial pressure, heart rate, and respiratory rate were also considered and these results were further correlated with TCCD findings. The groups were divided into three groups based on GCS, pupillary reactivity, and imaging. Imaging was done to indicate the etiology for ICP changes and also to look for signs of raised ICP. Results: Ten distinct types of waveform patterns were noted, and these waveforms correlated with various physiological parameters suggestive of raised ICP. Conclusion: The sequential evolution of distinct patterns of Doppler waveform with increasing degree of raise in ICP has been described and can act as a quick screening tool in NICU and helps stratify patients for treatment and prognostication. PMID:28904458

  12. Association between diastolic dysfunction by color tissue Doppler imaging and vascular calcification on plain radiographs in dialysis patients.

    PubMed

    An, Won Suk; Lee, Su Mi; Park, Tae Ho; Kim, Seong Eun; Kim, Ki Hyun; Park, Young Jin; Son, Young Ki

    2012-01-01

    Diastolic dysfunction is frequently associated with left ventricular hypertrophy, which is indicative of future cardiovascular events. Vascular calcification (VC) is known to be associated with coronary artery disease in dialysis patients. The present study was to determine the interrelationship between LV diastolic dysfunction by tissue Doppler imaging and VC on plain radiographs in dialysis patients. Fifty-six dialysis patients were recruited and VC scores were evaluated by plain radiographic film. The ratio of early diastolic transmitral inflow velocity (E) to early diastolic mitral annular velocity (E') was measured by tissue Doppler imaging. We defined diastolic dysfunction as an E/E' ratio >15 on tissue Doppler imaging. Patients with diastolic dysfunction showed a higher percentage of coronary artery disease history, abdominal aortic calcification (AAC) scores ≥5, high LV mass index, and high left atrium volume compared to patients without diastolic dysfunction. The E/E' ratio was significantly higher in patients with significant VC, VC scores of the pelvis and hands ≥3, and AAC scores ≥5 on plain radiographs. AAC scores ≥5 were considered an independent predictor of diastolic dysfunction. VC on plain radiographs is associated with the E/E' ratio and AAC scores ≥5 are important clues for LV diastolic dysfunction in dialysis patients. Copyright © 2012 S. Karger AG, Basel.

  13. Quantitative Contrast-Enhanced Ultrasound Parameters in Crohn Disease: Their Role in Disease Activity Determination With Ultrasound.

    PubMed

    Medellin-Kowalewski, Alexandra; Wilkens, Rune; Wilson, Alexandra; Ruan, Ji; Wilson, Stephanie R

    2016-01-01

    The primary objective of our study was to examine the association between contrast-enhanced ultrasound (CEUS) parameters and established gray-scale ultrasound with color Doppler imaging (CDI) for the determination of disease activity in patients with Crohn disease. Our secondary objective was to develop quantitative time-signal intensity curve thresholds for disease activity. One hundred twenty-seven patients with Crohn disease underwent ultrasound with CDI and CEUS. Reviewers graded wall thickness, inflammatory fat, and mural blood flow as showing remission or inflammation (mild, moderate, or severe). If both gray-scale ultrasound and CDI predicted equal levels of disease activity, the studies were considered concordant. If ultrasound images suggested active disease not supported by CDI findings, the ultrasound results for disease activity were indeterminate. Time-signal intensity curves from CEUS were acquired with calculation of peak enhancement (PE), and AUCs. Interobserver variation and associations between PE and ultrasound parameters were examined. Multiclass ROC analysis was used to develop CEUS thresholds for activity. Ninety-six (76%) studies were concordant, 19 of which showed severe disease, and 31 (24%) studies were indeterminate. Kappa analyses revealed good interobserver agreement on grades for CDI (κ = 0.76) and ultrasound (κ = 0.80) assessments. PE values on CEUS and wall thickness showed good association with the Spearman rank correlation coefficient for the entire population (ρ = 0.62, p < 0.01) and for the concordant group (ρ = 0.70, p < 0.01). Multiclass ROC analyses of the concordant group using wall thickness alone as the reference standard showed cutoff points of 18.2 dB for differentiating mild versus moderate activity (sensitivity, 89.0% and specificity, 87.0%) and 23.0 dB for differentiating moderate versus severe (sensitivity, 90% and specificity, 86.8%). Almost identical cutoff points were observed when using ultrasound global

  14. Intraventricular vorticity favors conservation of kinetic energy along the cardiac cycle: analysis in patients with dilated cardiomyopathy by post-processing color-doppler images

    NASA Astrophysics Data System (ADS)

    Alhama, Marta; Benito, Yolanda; Bermejo, Javier; Yotti, Raquel; Perez-David, Esther; Barrio, Alicia; Perez Del Villar, Candelas; Gonzalez Mansilla, Ana; Fernandez Aviles, Francisco; Del Alamo, Juan Carlos

    2011-11-01

    Background: This study assesses if the left ventricle (LV) filling vortex developed during diastole may be a mechanism that improves systolic efficiency. 19 patients with dilated cardiomyopathy (DCM) and 37 healthy volunteers were studied. Recently, we have developed and validated a method that derives two-dimensional maps of the LV flow from standard color-Doppler sequences. Two-dimensional maps of instantaneous LV flow were obtained, and circulation, energy and position of the main and secondary vortices were calculated along the cardiac cycle. At aortic valve opening (AVO) the vortex circulation is higher in DCM subjects than healthy volunteers. However, the position of the vortex is farthest form LV outflow tract (LVOT), and this results in lower flow velocity in LVOT at AVO. This phenomenon is altered in patients with DCM. Supported by ISCIII (Spain) and NIH 1 R21 HL108268-01 (US).

  15. Different imaging methods in the comparative assessment of vascular lesions: color-coded duplex sonography, laser Doppler perfusion imaging, and infrared thermography

    NASA Astrophysics Data System (ADS)

    Urban, Peter; Philipp, Carsten M.; Weinberg, Lutz; Berlien, Hans-Peter

    1997-12-01

    Aim of the study was the comparative investigation of cutaneous and subcutaneous vascular lesions. By means of color coded duplex sonography (CCDS), laser doppler perfusion imaging (LDPI) and infrared thermography (IT) we examined hemangiomas, vascular malformations and portwine stains to get some evidence about depth, perfusion and vascularity. LDI is a helpful method to get an impression of the capillary part of vascular lesions and the course of superficial vessels. CCDS has disadvantages in the superficial perfusion's detection but connections to deeper vascularizations can be examined precisely, in some cases it is the only method for visualizing vascular malformations. IT gives additive hints on low blood flow areas or indicates arterial-venous-shunts. Only the combination of all imaging methods allows a complete assessment, not only for planning but also for controlling the laser treatment of vascular lesions.

  16. Quantitative analysis of vascular heterogeneity in breast lesions using contrast-enhanced 3-D harmonic and subharmonic ultrasound imaging.

    PubMed

    Sridharan, Anush; Eisenbrey, John R; Machado, Priscilla; Ojeda-Fournier, Haydee; Wilkes, Annina; Sevrukov, Alexander; Mattrey, Robert F; Wallace, Kirk; Chalek, Carl L; Thomenius, Kai E; Forsberg, Flemming

    2015-03-01

    Ability to visualize breast lesion vascularity and quantify the vascular heterogeneity using contrast-enhanced 3-D harmonic (HI) and subharmonic (SHI) ultrasound imaging was investigated in a clinical population. Patients (n = 134) identified with breast lesions on mammography were scanned using power Doppler imaging, contrast-enhanced 3-D HI, and 3-D SHI on a modified Logiq 9 scanner (GE Healthcare). A region of interest corresponding to ultrasound contrast agent flow was identified in 4D View (GE Medical Systems) and mapped to raw slice data to generate a map of time-intensity curves for the lesion volume. Time points corresponding to baseline, peak intensity, and washout of ultrasound contrast agent were identified and used to generate and compare vascular heterogeneity plots for malignant and benign lesions. Vascularity was observed with power Doppler imaging in 84 lesions (63 benign and 21 malignant). The 3-D HI showed flow in 8 lesions (5 benign and 3 malignant), whereas 3-D SHI visualized flow in 68 lesions (49 benign and 19 malignant). Analysis of vascular heterogeneity in the 3-D SHI volumes found benign lesions having a significant difference in vascularity between central and peripheral sections (1.71 ± 0.96 vs. 1.13 ± 0.79 dB, p < 0.001, respectively), whereas malignant lesions showed no difference (1.66 ± 1.39 vs. 1.24 ± 1.14 dB, p = 0.24), indicative of more vascular coverage. These preliminary results suggest quantitative evaluation of vascular heterogeneity in breast lesions using contrast-enhanced 3-D SHI is feasible and able to detect variations in vascularity between central and peripheral sections for benign and malignant lesions.

  17. Quantitative Analysis of Vascular Heterogeneity in Breast Lesions Using Contrast-Enhanced 3-D Harmonic and Subharmonic Ultrasound Imaging

    PubMed Central

    Sridharan, Anush; Eisenbrey, John R.; Machado, Priscilla; Ojeda-Fournier, Haydee; Wilkes, Annina; Sevrukov, Alexander; Mattrey, Robert F.; Wallace, Kirk; Chalek, Carl L.; Thomenius, Kai E.; Forsberg, Flemming

    2015-01-01

    Ability to visualize breast lesion vascularity and quantify the vascular heterogeneity using contrast-enhanced 3-D harmonic (HI) and subharmonic (SHI) ultrasound imaging was investigated in a clinical population. Patients (n = 134) identified with breast lesions on mammography were scanned using power Doppler imaging, contrast-enhanced 3-D HI, and 3-D SHI on a modified Logiq 9 scanner (GE Healthcare). A region of interest corresponding to ultrasound contrast agent flow was identified in 4D View (GE Medical Systems) and mapped to raw slice data to generate a map of time-intensity curves for the lesion volume. Time points corresponding to baseline, peak intensity, and washout of ultrasound contrast agent were identified and used to generate and compare vascular heterogeneity plots for malignant and benign lesions. Vascularity was observed with power Doppler imaging in 84 lesions (63 benign and 21 malignant). The 3-D HI showed flow in 8 lesions (5 benign and 3 malignant), whereas 3-D SHI visualized flow in 68 lesions (49 benign and 19 malignant). Analysis of vascular heterogeneity in the 3-D SHI volumes found benign lesions having a significant difference in vascularity between central and peripheral sections (1.71 ± 0.96 vs. 1.13 ± 0.79 dB, p < 0.001, respectively), whereas malignant lesions showed no difference (1.66 ± 1.39 vs. 1.24 ± 1.14 dB, p = 0.24), indicative of more vascular coverage. These preliminary results suggest quantitative evaluation of vascular heterogeneity in breast lesions using contrast-enhanced 3-D SHI is feasible and able to detect variations in vascularity between central and peripheral sections for benign and malignant lesions. PMID:25935933

  18. Dynamic Contrast-Enhanced MRI of Cervical Cancers: Temporal Percentile Screening of Contrast Enhancement Identifies Parameters for Prediction of Chemoradioresistance

    SciTech Connect

    Andersen, Erlend K.F.; Hole, Knut Hakon; Lund, Kjersti V.; Sundfor, Kolbein; Kristensen, Gunnar B.; Lyng, Heidi; Malinen, Eirik

    2012-03-01

    Purpose: To systematically screen the tumor contrast enhancement of locally advanced cervical cancers to assess the prognostic value of two descriptive parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods and Materials: This study included a prospectively collected cohort of 81 patients who underwent DCE-MRI with gadopentetate dimeglumine before chemoradiotherapy. The following descriptive DCE-MRI parameters were extracted voxel by voxel and presented as histograms for each time point in the dynamic series: normalized relative signal increase (nRSI) and normalized area under the curve (nAUC). The first to 100th percentiles of the histograms were included in a log-rank survival test, resulting in p value and relative risk maps of all percentile-time intervals for each DCE-MRI parameter. The maps were used to evaluate the robustness of the individual percentile-time pairs and to construct prognostic parameters. Clinical endpoints were locoregional control and progression-free survival. The study was approved by the institutional ethics committee. Results: The p value maps of nRSI and nAUC showed a large continuous region of percentile-time pairs that were significantly associated with locoregional control (p < 0.05). These parameters had prognostic impact independent of tumor stage, volume, and lymph node status on multivariate analysis. Only a small percentile-time interval of nRSI was associated with progression-free survival. Conclusions: The percentile-time screening identified DCE-MRI parameters that predict long-term locoregional control after chemoradiotherapy of cervical cancer.

  19. Prospective comparison of use of contrast-enhanced ultrasound and contrast-enhanced computed tomography in the Bosniak classification of complex renal cysts

    PubMed Central

    Ragel, Matthew; Nedumaran, Anbu

    2016-01-01

    Aim To compare contrast-enhanced ultrasound and contrast-enhanced computed tomography in the evaluation of complex renal cysts using the Bosniak classification. Methods Forty-six patients with 51 complex renal cysts were prospectively examined using contrast-enhanced ultrasound and contrast-enhanced computed tomography and images analysed by two observers using the Bosniak classification. Adverse effects and patients’ preference were assessed for both modalities. Results There was complete agreement in Bosniak classification between both modalities and both observers in six cysts (11.8%). There was agreement of Bosniak classification on both modalities in 21 of 51 cysts (41.2%) for observer 1 and in 17 of 51 cysts (33.3%) for observer 2. Contrast-enhanced ultrasound gave a higher Bosniak classification than corresponding contrast-enhanced computed tomography in 31 % of cysts by both observers. Histological correlation was available in three lesions, all of which were malignant and classified as such simultaneously on both modalities by at least one observer, with remaining patients followed up with US or CT for 6–24 months. No adverse or side effects were reported following the use of US contrast, whilst 63.6% of patients suffered minor side effects following the use of CT contrast. 81.8% of the surveyed patients preferred contrast-enhanced ultrasound to contrast-enhanced computed tomography. Conclusion Contrast-enhanced ultrasound is a feasible tool in the evaluation of complex renal cysts in a non-specialist setting. Increased contrast-enhanced ultrasound sensitivity to enhancement compared to contrast-enhanced computed tomography, resulting in upgrading the Bosniak classification on contrast-enhanced ultrasound, has played a role in at best moderate agreement recorded by the observers with limited experience, but this would be overcome as the experience grows. To this end, we propose a standardised proforma for the contrast-enhanced ultrasound report. The

  20. Color Doppler ultrasound-guided botulinum toxin type A injection combined with an ankle foot brace for treating lower limb spasticity after a stroke.

    PubMed

    Ding, X-D; Zhang, G-B; Chen, H-X; Wang, W; Song, J-H; Fu, D-G

    2015-01-01

    To explore the effectiveness of the color Doppler ultrasound-guided botulinum toxin type A (BTX-A) injection combined with an ankle foot brace (AFO) for treating lower limb spasticity after a stroke. A total of 103 post-stroke patients with lower limb spasticity were divided into three groups: the control group treated with conventional therapy and rehabilitation training, the observation group treated with conventional therapy, rehabilitation training and botulinum toxin type A injection, the treatment group treated with AFO plus the same treatment received by the observation group. The muscle spasms were evaluated using the Clinic Spasticity Influx (CSI), movement with the Fugl-Meyer Assessment (FMA), dynamic and static balance with the Berg Balance Scale (BBS), and daily life activities with the Functional Independence Measure (FIM), respectively. Compared the first month after treatment with the prior treatment, there were significant differences in CSI, FMA and FIM scores in both control group and the observation group (p < 0.05). However, no differences were noticed in the control group (p > 0.05). Compared the third and sixth month after treatment with prior treatment, there were significant differences in these three groups (p < 0.05). In terms of treatment time, the BBS scores were always higher in all three groups after one month, three months and six months treatment than prior treatment (p < 0.05), and there were significant differences in third month and sixth month after treatment compared with the first month treatment (p < 0.05). Compared the third month after treatment with the sixth month, there were significant differences in all three groups (p < 0.05). The color Doppler ultrasound-guided BTX-A injection combined with AFO can effectively promote patients with post-stroke lower limb spasticity in lower limb muscle spasm, movement, balance and daily life activities.

  1. [Contrast enhanced ultrasound in the liver using low mechanical index--what is the difference?].

    PubMed

    Becker, D

    2002-12-01

    Echo-enhancing agents (EEA), also known as ultrasound contrast media, have improved the diagnostic potential of gastroenterologic ultrasound within the last years. Initially used to increase color-Doppler signals the potential to use harmonic waves being generated by the use of EEAs was established later. The effect was based upon the distraction of the EEA bubbles and the resulting pseudo-Doppler signal, the exam was carried out with high ultrasound energy and intermittent switching on and off of the ultrasound beam. Using this effect in real-time during continuous scanning is possible since the introduction of new EEAs with a flexible shell. This flexible shell oscillates during the scan process emitting harmonic signals. This new technology opens new possibilities for the detection of liver tumors including the possible characterisation. The detection rate for liver metastases can be increased by app. 40 % with this new technology. Correct sonographic characterisation of liver tumors can be achieved in nearly 100 % more cases.

  2. Hepatic Fibrosis: Evaluation with Semiquantitative Contrast-enhanced CT

    PubMed Central

    Varenika, Vanja; Fu, Yanjun; Maher, Jacquelyn J.; Gao, Dongwei; Kakar, Sanjay; Cabarrus, Miguel C.

    2013-01-01

    Purpose: To evaluate the feasibility of using contrast material–enhanced computed tomographic (CT) measurements of hepatic fractional extracellular space (fECS) and macromolecular contrast material (MMCM) uptake to measure severity of liver fibrosis. Materials and Methods: All procedures were approved by and executed in accordance with University of California, San Francisco, institutional animal care and use committee regulations. Twenty-one rats that received intragastric CCl4 for 0–12 weeks were imaged with respiratory-gated micro-CT by using both a conventional contrast material and a novel iodinated MMCM. Histopathologic hepatic fibrosis was graded qualitatively by using the Ishak fibrosis score and quantitatively by using morphometry of the fibrosis area. Hepatic fECS and MMCM uptake were calculated for each examination and correlated with histopathologic findings by using uni- and multivariate linear regressions. Results: Ishak fibrosis scores ranged from a baseline of 0 in untreated animals to a maximum of 5. Histopathologic liver fibrosis area increased from 0.46% to 3.5% over the same interval. Strong correlations were seen between conventional contrast-enhanced CT measurements of fECS and both the Ishak fibrosis scores (R2 = 0.751, P < .001) and the fibrosis area (R2 = 0.801, P < .001). Strong negative correlations were observed between uptake of MMCM in the liver and Ishak fibrosis scores (R2 = 0.827, P < .001), as well as between uptake of MMCM in the liver and fibrosis area (R2 = 0.643, P = .001). Multivariate linear regression analysis showed a trend toward independence for fECS and MMCM uptake in the prediction of Ishak fibrosis scores, with an R2 value of 0.86 (P = .081 and P = .033, respectively). Conclusion: Contrast-enhanced CT measurements of fECS and MMCM uptake are individually capable of being used to estimate the degree of early hepatic fibrosis in a rat model. © RSNA, 2012 Supplemental material: http

  3. Contrast-enhanced fluorodeoxyglucose positron emission tomography/contrast-enhanced computed tomography in mediastinal T-cell lymphoma with superior vena cava syndrome.

    PubMed

    Santhosh, Sampath; Gorla, Arun Kumar Reddy; Bhattacharya, Anish; Varma, Subhash Chander; Mittal, Bhagwant Rai

    2016-01-01

    Positron emission tomography-computed tomography (PET/CT) is a routine investigation for the staging of lymphomas. Contrast-enhanced computed tomography is mandatory whenever parenchymal lesions, especially in the liver and spleen are suspected. We report a rare case of primary mediastinal T-cell lymphoma evaluated with contrast-enhanced PET/CT that showed features of superior vena cava syndrome.

  4. Evaluation of the three-time-point method for diagnosis of breast lesions in contrast-enhanced MR mammography.

    PubMed

    Hauth, Elke A M; Stockamp, Christin; Maderwald, Stefan; Mühler, Andreas; Kimmig, Rainer; Jaeger, Horst; Barkhausen, Jörg; Forsting, Michael

    2006-01-01

    To evaluate the three-time-point (3TP) method for diagnosis of breast lesions detected on contrast-enhanced MR mammography. MR imaging was performed in 40 women with 120 suspected breast lesions in mammography and/or sonography. The contrast kinetics was converted by 3TP software on a pixel-by-pixel basis into color-coded images. Lesion diagnosis was made by analysis of color intensity and color hue. The 3TP results were compared with the results of the region-of-interest (ROI) method. In 16 patients, we were able to correlate the results with histopathological findings. The 3TP method could successfully be performed in all MR mammographies. Forty (33%) lesions had a diameter of less than 5 mm, 56 (47%) lesions between 5 and 10 mm, and 24 (20%) lesions were greater than 1 cm. Of all 120 lesions, 65 (54%) showed heterogeneous contrast enhancement. In 117 (97%) of all 120 lesions the results of ROI and the automated 3TP method were considered equivalent. However, in three lesions the manual ROI differed from the 3TP method. After a second, repeated manual ROI placement, we were able to confirm equivalent results with the 3TP images as well. The 3TP method automatically and reliably converts contrast kinetic information of the entire breast into a color-coded image. The 3TP method presents kinetic information of the entire dynamic series in an easy-to-interpret format and this automated method may allow to forego time-consuming and sometimes subjective manual ROI placements. This method displays the heterogeneity of the contrast enhancement pattern often observed in malignant lesions and makes it usable as diagnostic criterion.

  5. Severe Portal Hypertension in Cirrhosis: Evaluation of Perfusion Parameters with Contrast-Enhanced Ultrasonography

    PubMed Central

    Sohn, Joo Hyun; Kim, Yongsoo; Kim, Jinoo

    2015-01-01

    Objective To investigate the role of contrast-enhanced ultrasonography (CEUS) and Doppler ultrasonography (DUS) in the diagnosis of severe portal hypertension (PH) in patients with liver cirrhosis (LC). Methods Patients with PH scheduled to receive hepatic venous pressure gradient (HVPG) measurement were recruited for this study. Hepatic DUS and CEUS were performed successively. Several Doppler and CEUS parameters were explored for correlation with HVPG values and their association with severe PH (≥ 12 mmHg of HVPG). Comparison of the parameters between the severe and non-severe PH groups and their correlation with HVPG values was evaluated. A receiver operating characteristic (ROC) curve analysis was also performed to investigate the performance in order to diagnose severe PH. Results Fifty-three consecutive patients were enrolled in this study. Among them, 43 patients did not have significant ascites. Compared with the non-severe PH group, portal venous velocity and intrahepatic transit time (ITT) were significantly reduced in the severe PH group (all p<0.05). Difference between inspiratory and expiratory hepatic venous damping indices (ΔHVDI), hepatic venous arrival time (HVAT) and ITT moderately correlated with HVPG (r = -0.358, -0.338, and -0.613, respectively). Areas under the curves for severe PH were 0.94 of ITT and 0.72 of HVAT, respectively (all p<0.05). ITT under 6 seconds indicated severe PH with a sensitivity of 92% and a specificity of 89%. Conclusions Hepatic CEUS may be more useful in estimating the HVPG value and determining the presence of severe PH compared to DUS, and ITT was the most accurate parameter to diagnose severe PH. PMID:25798930

  6. Nanoparticles and nanostructured carriers for drug delivery and contrast enhancement

    NASA Astrophysics Data System (ADS)

    Godage, Olga S.; Bucharskaya, Alla B.; Navolokin, Nikita A.; German, Sergey V.; Zuev, Viktor V.; Terentyuk, Georgy S.; Maslyakova, Galina N.; Gorin, Dmitry A.

    2016-04-01

    Currently, nanotechnologies are widely used in science and industry. It is known that the application of drug delivery nanostructured carriers for biomedicine is one of the promising areas of nanotechnology. Nanostructured carriers can be used in the diagnosis process for detecting a neoplastic tumor cells in peripheral blood, for contrast enhancement on magnetic resonance imaging (MRI), as well as for targeted drug delivery to tumor tissues. Agents for the targeted delivery (nanoparticles, liposomes, microcapsules, and etc) can affect the healthy tissues and organs, cause side effects and have a toxic effect. Therefore, it necessary to study the morphological changes that occur not only in the "target", such as a tumor, but also the internal organs, taking place under the influence of both the agents for targeted drug delivery and physical impact induced remote controlled drug release. Thus , the aim of our work is selection of the most promising agents for targeted drug delivery to tumor and contrast agents for in vivo visualization of tumor tissue boundaries , as well as their impact on the organs and tissues as results of nanostructured object biodistribution.

  7. Motion correction of dynamic contrast enhanced MRI of the liver

    NASA Astrophysics Data System (ADS)

    Jansen, Mariëlle J. A.; Veldhuis, Wouter B.; van Leeuwen, Maarten S.; Pluim, Josien P. W.

    2017-02-01

    Motion correction of dynamic contrast enhanced magnetic resonance images (DCE-MRI) is a challenging task, due to changes in image appearance. In this study a groupwise registration, using a principle component analysis (PCA) based metric, is evaluated for clinical DCE MRI of the liver. The groupwise registration transforms the images to a common space, rather than to a reference volume as conventional pairwise methods do, and computes the similarity metric on all volumes simultaneously. This groupwise registration method is compared to a pairwise approach using a mutual information metric. Clinical DCE MRI of the abdomen of eight patients were included. Per patient one lesion in the liver was manually segmented in all temporal images (N=16). The registered images were compared for accuracy, spatial and temporal smoothness after transformation, and lesion volume change. Compared to a pairwise method or no registration, groupwise registration provided better alignment. In our recently started clinical study groupwise registered clinical DCE MRI of the abdomen of nine patients were scored by three radiologists. Groupwise registration increased the assessed quality of alignment. The gain in reading time for the radiologist was estimated to vary from no difference to almost a minute. A slight increase in reader confidence was also observed. Registration had no added value for images with little motion. In conclusion, the groupwise registration of DCE MR images results in better alignment than achieved by pairwise registration, which is beneficial for clinical assessment.

  8. Contrast-enhanced ultrasound of histologically proven hepatic epithelioid hemangioendothelioma

    PubMed Central

    Dong, Yi; Wang, Wen-Ping; Cantisani, Vito; D’Onofrio, Mirko; Ignee, Andre; Mulazzani, Lorenzo; Saftoiu, Adrian; Sparchez, Zeno; Sporea, Ioan; Dietrich, Christoph F

    2016-01-01

    AIM: To analyze contrast-enhanced ultrasound (CEUS) features of histologically proven hepatic epithelioid hemangioendothelioma (HEHE) in comparison to other multilocular benign focal liver lesions (FLL). METHODS: Twenty-five patients with histologically proven HEHE and 45 patients with histologically proven multilocular benign FLL were retrospectively reviewed. Four radiologists assessed the CEUS enhancement pattern in consensus. RESULTS: HEHE manifested as a single (n = 3) or multinodular (n = 22) FLL. On CEUS, HEHE showed rim-like (18/25, 72%) or heterogeneous hyperenhancement (7/25, 28%) in the arterial phase and hypoenhancement (25/25, 100%) in the portal venous and late phases (PVLP), a sign of malignancy. Eighteen patients showed central unenhanced areas (18/25, 72%); in seven patients (7/25, 28%), more lesions were detected in the PVLP. In contrast, all patients with hemangioma and focal nodular hyperplasia showed hyperenhancement as the most distinctive feature (P < 0.01). CONCLUSION: CEUS allows for characterization of unequivocal FLL. By analyzing the hypoenhancement in the PVLP, CEUS can determine the malignant nature of HEHE. PMID:27217705

  9. Cumulative phase delay imaging for contrast-enhanced ultrasound tomography

    NASA Astrophysics Data System (ADS)

    Demi, Libertario; van Sloun, Ruud J. G.; Wijkstra, Hessel; Mischi, Massimo

    2015-11-01

    Standard dynamic-contrast enhanced ultrasound (DCE-US) imaging detects and estimates ultrasound-contrast-agent (UCA) concentration based on the amplitude of the nonlinear (harmonic) components generated during ultrasound (US) propagation through UCAs. However, harmonic components generation is not specific to UCAs, as it also occurs for US propagating through tissue. Moreover, nonlinear artifacts affect standard DCE-US imaging, causing contrast to tissue ratio reduction, and resulting in possible misclassification of tissue and misinterpretation of UCA concentration. Furthermore, no contrast-specific modality exists for DCE-US tomography; in particular speed-of-sound changes due to UCAs are well within those caused by different tissue types. Recently, a new marker for UCAs has been introduced. A cumulative phase delay (CPD) between the second harmonic and fundamental component is in fact observable for US propagating through UCAs, and is absent in tissue. In this paper, tomographic US images based on CPD are for the first time presented and compared to speed-of-sound US tomography. Results show the applicability of this marker for contrast specific US imaging, with cumulative phase delay imaging (CPDI) showing superior capabilities in detecting and localizing UCA, as compared to speed-of-sound US tomography. Cavities (filled with UCA) which were down to 1 mm in diameter were clearly detectable. Moreover, CPDI is free of the above mentioned nonlinear artifacts. These results open important possibilities to DCE-US tomography, with potential applications to breast imaging for cancer localization.

  10. Image fusion for dynamic contrast enhanced magnetic resonance imaging

    PubMed Central

    Twellmann, Thorsten; Saalbach, Axel; Gerstung, Olaf; Leach, Martin O; Nattkemper, Tim W

    2004-01-01

    Background Multivariate imaging techniques such as dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) have been shown to provide valuable information for medical diagnosis. Even though these techniques provide new information, integrating and evaluating the much wider range of information is a challenging task for the human observer. This task may be assisted with the use of image fusion algorithms. Methods In this paper, image fusion based on Kernel Principal Component Analysis (KPCA) is proposed for the first time. It is demonstrated that a priori knowledge about the data domain can be easily incorporated into the parametrisation of the KPCA, leading to task-oriented visualisations of the multivariate data. The results of the fusion process are compared with those of the well-known and established standard linear Principal Component Analysis (PCA) by means of temporal sequences of 3D MRI volumes from six patients who took part in a breast cancer screening study. Results The PCA and KPCA algorithms are able to integrate information from a sequence of MRI volumes into informative gray value or colour images. By incorporating a priori knowledge, the fusion process can be automated and optimised in order to visualise suspicious lesions with high contrast to normal tissue. Conclusion Our machine learning based image fusion approach maps the full signal space of a temporal DCE-MRI sequence to a single meaningful visualisation with good tissue/lesion contrast and thus supports the radiologist during manual image evaluation. PMID:15494072

  11. Contrast-enhanced ultrasound: clinical applications in patients with atherosclerosis.

    PubMed

    Schinkel, Arend F L; Kaspar, Mathias; Staub, Daniel

    2016-01-01

    Contrast-enhanced ultrasound (CEUS) is increasingly being used to evaluate patients with known or suspected atherosclerosis. The administration of a microbubble contrast agent in conjunction with ultrasound results in an improved image quality and provides information that cannot be assessed with standard B-mode ultrasound. CEUS is a high-resolution, noninvasive imaging modality, which is safe and may benefit patients with coronary, carotid, or aortic atherosclerosis. CEUS allows a reliable assessment of endocardial borders, left ventricular function, intracardiac thrombus and myocardial perfusion. CEUS results in an improved detection of carotid atherosclerosis, and allows assessment of high-risk plaque characteristics including intraplaque vascularization, and ulceration. CEUS provides real-time bedside information in patients with a suspected or known abdominal aortic aneurysm or aortic dissection. The absence of ionizing radiation and safety of the contrast agent allow repetitive imaging which is particularly useful in the follow-up of patients after endovascular aneurysm repair. New developments in CEUS-based molecular imaging will improve the understanding of the pathophysiology of atherosclerosis and may in the future allow to image and directly treat cardiovascular diseases (theragnostic CEUS). Familiarity with the strengths and limitations of CEUS may have a major impact on the management of patients with atherosclerosis.

  12. Cerebellar dermoid cyst with contrast enhancement mural nodule: case report.

    PubMed

    Morina, Arsim; Kelmendi, Fatos; Morina, Qamile; Morina, Dukagjin

    2014-12-01

    Typical dermoid cysts are well-circumscribed fat-density masses with no associated contrast enhancement; rarely, they may appear hyperattenuating on CT scan. CT hyperattenuating dermoid cyst (CHADC) is very uncommon, with only nine case reports in the literature update, which occurs exclusively in the posterior fossa. CHADC with mural nodule is extremely rare and, to the best of our knowledge, only two cases have been documented previously in the literature. A 49-year-old farmer had a 2-month history of occipital headaches, which were not suggestive of raised intracranial pressure. During the last month, he experienced loss of balance, frequent falls, anorexia and loss of weight. Magnetic resonance imaging (MRI) showed a huge mass from the tentorium to the foramen occipitale magnum with obliteration of the fourth ventricle; the lesion was well circumscribed. We completely removed the tumor and postoperative MRI showed no residual tumor. Epidermoid tumors with enhancing mural nodule on MRI and with hyperattenuating lesion on CT are extremely rare. Dermoid cysts are never associated with edema and extremely rarely cause obstructive hydrocephalus. MRI investigations are mandatory to diagnose these cases. The best curative treatment is total removal of the lesion.

  13. Dynamic Contrast-Enhanced CT in Patients with Pancreatic Cancer

    PubMed Central

    Eriksen, Rie Ø.; Strauch, Louise S.; Sandgaard, Michael; Kristensen, Thomas S.; Nielsen, Michael B.; Lauridsen, Carsten A.

    2016-01-01

    The aim of this systematic review is to provide an overview of the use of Dynamic Contrast-enhanced Computed Tomography (DCE-CT) in patients with pancreatic cancer. This study was composed according to the PRISMA guidelines 2009. The literature search was conducted in PubMed, Cochrane Library, EMBASE, and Web of Science databases to identify all relevant publications. The QUADAS-2 tool was implemented to assess the risk of bias and applicability concerns of each included study. The initial literature search yielded 483 publications. Thirteen articles were included. Articles were categorized into three groups: nine articles concerning primary diagnosis or staging, one article about tumor response to treatment, and three articles regarding scan techniques. In exocrine pancreatic tumors, measurements of blood flow in eight studies and blood volume in seven studies were significantly lower in tumor tissue, compared with measurements in pancreatic tissue outside of tumor, or normal pancreatic tissue in control groups of healthy volunteers. The studies were heterogeneous in the number of patients enrolled and scan protocols. Perfusion parameters measured and analyzed by DCE-CT might be useful in the investigation of characteristic vascular patterns of exocrine pancreatic tumors. Further clinical studies are desired for investigating the potential of DCE-CT in pancreatic tumors. PMID:27608045

  14. Diagnosis of liver cirrhosis with contrast-enhanced ultrasound

    PubMed Central

    Liu, Guang-Jian; Lu, Ming-De

    2010-01-01

    The assessment of the extent of liver fibrosis is very important for the prognosis and clinical management of chronic liver diseases. Although liver biopsy is the gold standard for the assessment of liver fibrosis, new non-invasive diagnostic methods are urgently needed in clinical work due to certain limitations and complications of biopsy. Noninvasive imaging studies play an important role in the diagnosis of focal liver disease and diffuse liver diseases. Among them, ultrasonography is the first choice for study of the liver in clinical work. With the development of ultrasound contrast agents and contrast specific imaging techniques, contrast-enhanced ultrasound (CEUS) shows good performance and great potential in the evaluation of liver fibrosis. Researchers have tried different kinds of contrast agent and imaging method, such as arrival time of contrast agent in the hepatic vein, and quantitative analysis of the enhancement level of liver parenchyma, to evaluate the degree of liver fibrosis during the past 10 years. This review mainly summarizes the clinical studies concerning the assessment of liver fibrosis using CEUS. PMID:21160737

  15. Dynamic Contrast-Enhanced CT in Patients with Pancreatic Cancer.

    PubMed

    Eriksen, Rie Ø; Strauch, Louise S; Sandgaard, Michael; Kristensen, Thomas S; Nielsen, Michael B; Lauridsen, Carsten A

    2016-09-06

    The aim of this systematic review is to provide an overview of the use of Dynamic Contrast-enhanced Computed Tomography (DCE-CT) in patients with pancreatic cancer. This study was composed according to the PRISMA guidelines 2009. The literature search was conducted in PubMed, Cochrane Library, EMBASE, and Web of Science databases to identify all relevant publications. The QUADAS-2 tool was implemented to assess the risk of bias and applicability concerns of each included study. The initial literature search yielded 483 publications. Thirteen articles were included. Articles were categorized into three groups: nine articles concerning primary diagnosis or staging, one article about tumor response to treatment, and three articles regarding scan techniques. In exocrine pancreatic tumors, measurements of blood flow in eight studies and blood volume in seven studies were significantly lower in tumor tissue, compared with measurements in pancreatic tissue outside of tumor, or normal pancreatic tissue in control groups of healthy volunteers. The studies were heterogeneous in the number of patients enrolled and scan protocols. Perfusion parameters measured and analyzed by DCE-CT might be useful in the investigation of characteristic vascular patterns of exocrine pancreatic tumors. Further clinical studies are desired for investigating the potential of DCE-CT in pancreatic tumors.

  16. Simultaneous segmentation and registration of contrast-enhanced breast MRI.

    PubMed

    Xiaohua, Chen; Brady, Michael; Lo, Jonathan Lok-Chuen; Moore, Niall

    2005-01-01

    Breast Contrast-Enhanced MRI (ce-MRI) requires a series of images to be acquired before, and repeatedly after, intravenous injection of a contrast agent. Breast MRI segmentation based on the differential enhancement of image intensities can assist the clinician detect suspicious regions. Image registration between the temporal data sets is necessary to compensate for patient motion, which is quite often substantial. Although segmentation and registration are usually treated as separate problems in medical image analysis, they can naturally benefit a great deal from each other. In this paper, we propose a scheme for simultaneous segmentation and registration of breast ce-MRI. It is developed within a Bayesian framework, based on a maximum a posteriori estimation method. A pharmacokinetic model and Markov Random Field model have been incorporated into the framework in order to improve the performance of our algorithm. Our method has been applied to the segmentation and registration of clinical ce-MR images. The results show the potential of our methodology to extract useful information for breast cancer detection.

  17. Delineation of Tumor Habitats based on Dynamic Contrast Enhanced MRI.

    PubMed

    Chang, Yu-Cherng Channing; Ackerstaff, Ellen; Tschudi, Yohann; Jimenez, Bryan; Foltz, Warren; Fisher, Carl; Lilge, Lothar; Cho, HyungJoon; Carlin, Sean; Gillies, Robert J; Balagurunathan, Yoganand; Yechieli, Raphael L; Subhawong, Ty; Turkbey, Baris; Pollack, Alan; Stoyanova, Radka

    2017-08-29

    Tumor heterogeneity can be elucidated by mapping subregions of the lesion with differential imaging characteristics, called habitats. Dynamic Contrast Enhanced (DCE-)MRI can depict the tumor microenvironments by identifying areas with variable perfusion and vascular permeability, since individual tumor habitats vary in the rate and magnitude of the contrast uptake and washout. Of particular interest is identifying areas of hypoxia, characterized by inadequate perfusion and hyper-permeable vasculature. An automatic procedure for delineation of tumor habitats from DCE-MRI was developed as a two-part process involving: (1) statistical testing in order to determine the number of the underlying habitats; and (2) an unsupervised pattern recognition technique to recover the temporal contrast patterns and locations of the associated habitats. The technique is examined on simulated data and DCE-MRI, obtained from prostate and brain pre-clinical cancer models, as well as clinical data from sarcoma and prostate cancer patients. The procedure successfully identified habitats previously associated with well-perfused, hypoxic and/or necrotic tumor compartments. Given the association of tumor hypoxia with more aggressive tumor phenotypes, the obtained in vivo information could impact management of cancer patients considerably.

  18. Contrast-enhanced MRI of murine myocardial infarction - part II.

    PubMed

    Coolen, Bram F; Paulis, Leonie E M; Geelen, Tessa; Nicolay, Klaas; Strijkers, Gustav J

    2012-08-01

    Mouse models are increasingly used to study the pathophysiology of myocardial infarction in vivo. In this area, MRI has become the gold standard imaging modality, because it combines high spatial and temporal resolution functional imaging with a large variety of methods to generate soft tissue contrast. In addition, (target-specific) MRI contrast agents can be employed to visualize different processes in the cascade of events following myocardial infarction. Here, the MRI sequence has a decisive role in the detection sensitivity of a contrast agent. However, a straightforward translation of clinically available protocols for human cardiac imaging to mice is not feasible, because of the small size of the mouse heart and its extremely high heart rate. This has stimulated intense research in the development of cardiac MRI protocols specifically tuned to the mouse with regard to timing parameters, acquisition strategies, and ECG- and respiratory-triggering methods to find an optimal trade-off between sensitivity, scan time, and image quality. In this review, a detailed analysis is given of the pros and cons of different mouse cardiac MR imaging methodologies and their application in contrast-enhanced MRI of myocardial infarction. Copyright © 2012 John Wiley & Sons, Ltd.

  19. Development of contrast-enhanced rodent imaging using functional CT

    NASA Astrophysics Data System (ADS)

    Liang, Yun; Stantz, Keith M.; Krishnamurthi, Ganapathy; Steinmetz, Rosemary; Hutchins, Gary D.

    2003-05-01

    Micro-computed tomography (microCT) is capable of obtaining high-resolution images of skeletal tissues. However its image contrast among soft tissues remains inadequate for tumor detection. High speed functional computed tomography will be needed to image tumors by employing x-ray contrast medium. The functional microCT development will not only facilitate the image contrast enhancement among different tissues but also provide information of tumor physiology. To demonstrate the feasibility of functional CT in mouse imaging, sequential computed tomography is performed in mice after contrast material administration using a high-speed clinical CT scanner. Although the resolution of the clinical scanner is not sufficient to dissolve the anatomic details of rodents, bulky physiological parameters in major organs such as liver, kidney, pancreas, and ovaries (testicular) can be examined. For data analysis, a two-compartmental model is employed and implemented to characterize the tissue physiological parameters (regional blood flow, capillary permeability, and relative compartment volumes.) The measured contrast dynamics in kidneys are fitted with the compartmental model to derive the kidney tissue physiology. The study result suggests that it is feasible to extract mouse tissue physiology using functional CT imaging technology.

  20. A no-reference perceptual based contrast enhancement metric for ocean scenes in fog.

    PubMed

    Gibson, Kristofor Boyd; Nguyen, Truong Q

    2013-10-01

    In this paper, we develop a perceptually based contrast enhancement metric as a means to solve the problem of autonomously enhancing images degraded by fog that are perceptually pleasing to humans. A learning based approach is considered to develop the contrast enhancement using human observations and low-level contrast enhancement metrics based on the human vision system. In addition, we provide new low-level metrics based on the physics of the scene to improve the performance of existing contrast enhancement metrics. This paper shows that a contrast enhancement metric can be designed to mimic human preference.

  1. [Role of dynamic penile color Doppler echography in the evaluation of the patient with La Peyronie's disease].

    PubMed

    Cormio, L; Bettocchi, C; Zizzi, V; Sblendorio, D; Pace, G; Traficante, A

    1996-12-01

    From March 1995 to February 1996, sixteen consecutive patients with Peyronie's Disease (PD) were routinely submitted to penile dynamic colour-coded doppler ultrasonography (CCDU). The test yielded normal results in 6 patients who had no erectile problems and in other 4 patients who conversely complained of reduced erectile function. In the other 6 patients who complained of reduced erectile function, the test pointed out pure arteriogenic failure in 1 case, pure venogenic failure in 4, and mixed arteriogenic and venogenic failure in 1. CCDU enables a precise assessment of erectile function as well of the site, kind and entity of the penile curvature to be corrected. These data are very useful when planning the surgical approach for each patient.

  2. Assessment of Skeletal Muscle Perfusion using Contrast-Enhanced Ultrasonography: Technical Note

    PubMed Central

    Qureshi, Adnan I.; Saleem, Muhammad A.; Aytac, Emrah; Wallery, Shawn S.

    2017-01-01

    Background Intravenous contrast-enhanced ultrasonography is a recently developed technique for assessment of tissue perfusion, but has not been used for assessment of skeletal muscle perfusion. Methods We studied a 42-year-old woman in whom myonecrosis was suspected due to systemic vasculitis and ischemia. The biceps brachii (right) and quadriceps femoris (vastus medialis) on right-hand side and subsequently left-hand side were imaged. Intravenous bolus of activated perflutren lipid microspheres was injected and B-Flow color mode (brown color) was used within a selected region of interest to image the passage of contrast through muscle parenchyma throughout three cardiac cycles. Results Visual interpretation of muscle perfusion was performed based on the maximal intensity of contrast in the muscle, and the speed of contrast replenishment. No deficits were noted in the perfusion pattern. The arterial phase demonstrated stellate vascularity, centrifugal filling, and homogeneous hypervascularity at peak enhancement. Conclusions The bolus of contrast resulted in good signal persistence and satisfactory imaging for multiple muscle groups. PMID:28243350

  3. Dynamic contrast-enhanced MRI evaluation of cerebral cavernous malformations.

    PubMed

    Hart, Blaine L; Taheri, Saeid; Rosenberg, Gary A; Morrison, Leslie A

    2013-10-01

    The aim of this study is to quantitatively evaluate the behavior of CNS cavernous malformations (CCMs) using a dynamic contrast-enhanced MRI (DCEMRI) technique sensitive for slow transfer rates of gadolinium. The prospective study was approved by the institutional review board and was HIPPA compliant. Written informed consent was obtained from 14 subjects with familial CCMs (4 men and 10 women, ages 22-76 years, mean 48.1 years). Following routine anatomic MRI of the brain, DCEMRI was performed for six slices, using T1 mapping with partial inversion recovery (TAPIR) to calculate T1 values, following administration of 0.025 mmol/kg gadolinium DTPA. The transfer rate (Ki) was calculated using the Patlak model, and Ki within CCMs was compared to normal-appearing white matter as well as to 17 normal control subjects previously studied. All subjects had typical MRI appearance of CCMs. Thirty-nine CCMs were studied using DCEMRI. Ki was low or normal in 12 lesions and elevated from 1.4 to 12 times higher than background in the remaining 27 lesions. Ki ranged from 2.1E-6 to 9.63E-4 min(-1), mean 3.55E-4. Normal-appearing white matter in the CCM patients had a mean Ki of 1.57E-4, not statistically different from mean WM Ki of 1.47E-4 in controls. TAPIR-based DCEMRI technique permits quantifiable assessment of CCMs in vivo and reveals considerable differences not seen with conventional MRI. Potential applications include correlation with biologic behavior such as lesion growth or hemorrage, and measurement of drug effects.

  4. MRI of the human eye using magnetization transfer contrast enhancement.

    PubMed

    Lizak, M J; Datiles, M B; Aletras, A H; Kador, P F; Balaban, R S

    2000-11-01

    To determine the feasibility of using magnetization transfer contrast-enhanced magnetic resonance imaging (MRI) to track cataractous lens changes. A fast spin-echo sequence was modified to include a magnetization transfer contrast (MTC) preparation pulse train. This consisted of twenty 8.5-msec sinc pulses, 1200 Hz upfield from the water resonance and 1.2-Hz power. The MTC preparation pulse was followed by acquisition through fast spin-echo imaging. The imaging parameters were number of excitations (NEX) = 1, echo time (TE) = 14 msec, recovery time (TR) = 2 sec, echo train length of eight echos, and a matrix size of 256 x 160. To reduce motion artifacts, the volunteers were asked to fixate on a blinking LED. Normal and MTC-enhanced images were acquired from normal volunteers and volunteers with nuclear or cortical cataracts. The eye was adequately imaged, with few motion artifacts appearing. The lens was well resolved, despite the short T(2). The cornea and ciliary body were also clearly visible. In the lens, resolution of the epithelium and cortex were enhanced with MTC. In addition, contrast-to-noise ratios were measured for each image. Examination of the contrast-to-noise ratio confirmed that MTC increased the contrast between the nucleus and cortex. Unenhanced MRIs showed significant differences between the cortex of normal volunteers and volunteers with cataracts. MTC-enhanced images improved the sensitivity to changes in the nucleus. In this preliminary study, we were able to use MTC-enhanced MRI to obtain high-contrast images of the human lens. Regular and enhanced MRIs detected statistically significant differences between normal and cataractous lenses.

  5. Cumulative phase delay imaging - A new contrast enhanced ultrasound modality

    SciTech Connect

    Demi, Libertario Sloun, Ruud J. G. van; Mischi, Massimo; Wijkstra, Hessel

    2015-10-28

    Recently, a new acoustic marker for ultrasound contrast agents (UCAs) has been introduced. A cumulative phase delay (CPD) between the second harmonic and fundamental pressure wave field components is in fact observable for ultrasound propagating through UCAs. This phenomenon is absent in the case of tissue nonlinearity and is dependent on insonating pressure and frequency, UCA concentration, and propagation path length through UCAs. In this paper, ultrasound images based on this marker are presented. The ULA-OP research platform, in combination with a LA332 linear array probe (Esaote, Firenze Italy), were used to image a gelatin phantom containing a PVC plate (used as a reflector) and a cylindrical cavity measuring 7 mm in diameter (placed in between the observation point and the PVC plate). The cavity contained a 240 µL/L SonoVueO{sup ®} UCA concentration. Two insonating frequencies (3 MHz and 2.5 MHz) were used to scan the gelatine phantom. A mechanical index MI = 0.07, measured in water at the cavity location with a HGL-0400 hydrophone (Onda, Sunnyvale, CA), was utilized. Processing the ultrasound signals backscattered from the plate, ultrasound images were generated in a tomographic fashion using the filtered back-projection method. As already observed in previous studies, significantly higher CPD values are measured when imaging at a frequency of 2.5 MHz, as compared to imaging at 3 MHz. In conclusion, these results confirm the applicability of the discussed CPD as a marker for contrast imaging. Comparison with standard contrast-enhanced ultrasound imaging modalities will be the focus of future work.

  6. Dynamic Contrast-Enhanced MRI Evaluation of Cerebral Cavernous Malformations

    PubMed Central

    Hart, B. L.; Taheri, S.; Rosenberg, G. A.; Morrison, L. A.

    2013-01-01

    The aim of this study is to quantitatively evaluate the behavior of CNS cavernous malformations (CCMs) using a dynamic contrast-enhanced MRI (DCEMRI) technique sensitive for slow transfer rates of gadolinium. The prospective study was approved by the institutional review board and was HIPPA compliant. Written informed consent was obtained from 14 subjects with familial CCMs (4 men and 10 women, ages 22–76 years, mean 48.1 years). Following routine anatomic MRI of the brain, DCEMRI was performed for six slices, using T1 mapping with partial inversion recovery (TAPIR) to calculate T1 values, following administration of 0.025 mmol/kg gadolinium DTPA. The transfer rate (Ki) was calculated using the Patlak model, and Ki within CCMs was compared to normal-appearing white matter as well as to 17 normal control subjects previously studied. All subjects had typical MRI appearance of CCMs. Thirty-nine CCMs were studied using DCEMRI. Ki was low or normal in 12 lesions and elevated from 1.4 to 12 times higher than background in the remaining 27 lesions. Ki ranged from 2.1E–6 to 9.63E–4 min−1, mean 3.55E–4. Normal-appearing white matter in the CCM patients had a mean Ki of 1.57E–4, not statistically different from mean WM Ki of 1.47E–4 in controls. TAPIR-based DCEMRI technique permits quantifiable assessment of CCMs in vivo and reveals considerable differences not seen with conventional MRI. Potential applications include correlation with biologic behavior such as lesion growth or hemorrage, and measurement of drug effects. PMID:24323376

  7. Cumulative phase delay imaging - A new contrast enhanced ultrasound modality