DOCSLIB.ORG

Color Doppler Ultrasonography and Multislice Computer Tomography

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Color Doppler Ultrasonography and Multislice Computer Tomography Volumen 68, Broj 5 VOJNOSANITETSKI PREGLED Strana 423 UDC: 616.133-073 ORIGINAL ARTICLE DOI:10.2298/VSP1105423V Color Doppler ultrasonography and multislice computer tomography angiography in carotid plaque detection and characterization Primena kolor dopler ultrasonografije i višeslojne kompjuterizovane tomografske angiografije u otkrivanju i karakterizaciji karotidnog plaka Viktorija Vučaj-Ćirilović*, Miloš Lučić†, Kosta Petrović*, Olivera Nikolić*, Mira Govorčin*, Sanja Stojanović* *Clinical Center of Vojvodina, Radiology Department, Novi Sad, Serbia; †Vojvodina Institute of Oncology, Center for Imaging Diagnostics, Sremska Kamenica, Serbia Abstract 97%; for plaques with irregular surface CDU 75% : MSCTA 87%; for ulcerations CDU 54% : MSCTA 87%). Regarding Beckground/Aim. Cerebrovascular diseases are the third determination of plaque structure (mixed plaque CDU 66% leading cause of mortality in the world, following malignant : MSCTA 70%; correlation with HP findings CDU 94% : and cardiovascular diseases. Therefore, their timely and pre- MSCTA 96%) and localization (CDU 63% : MSCTA 65%), cise diagnostics is of great importance. The aim of this study and in terms of sensitivity and specificity, both methods was to compare duplex scan Color Doppler ultrasonogra- showed almost the same results. Also, there is no statistical phy (CDU) with multislice computed tomography angiog- difference between these two methods for the degree of raphy (MSCTA) in detection of morphological and func- stenosis (CDU 96% : MSCTA 98%). Conclusion. Athero- tional disorders at extracranial level of carotid arteries. sclerotic disease of extracranial part of carotid arteries pri- Methods. The study included 75 patients with 150 carotid marily affects population of middle-aged and elderly, arteries examined in the period from January 2008 to April showing more associated risk factors. Sensitivity and speci- 2009. The patients were firstly examined by CDU, then ficity of CDU and MSCTA regarding plaque composition, MSCTA, followed by the surgery of extracranial segment of the degree of stenosis and plaque localization are almost the carotid arteries. In 10 patients, the obtained material was re- same. These results and the fact that there are no adverse ef- ferred for histopathological (HP) examination. We used fects (high radiation dose) compared to MSCTA indicate that both CDU and MSCT in the analysis of: plaque surface, CDU should be the initial method in diagnostic algorythm for plaque structure, degree of stenosis, and the presence of in- carotid arteries. traplaque hemorrhage. Results. The results obtained by CDU and MSCTA were first compared between themselves, and Key words: then to intraoperative findings. Retrospective analysis showed ultrasonography, doppler, color; cerebral angiography; that MSCTA is more sensitive than CDU in assessment of carotid artery diseases; carotid stenosis; tomography, plaque surface (for smooth plaques CDU 89% : MSCTA x ray computed. Apstrakt MSCTA, a zatim operacija karotidnih arterija. Kod 10 bole- snika uzet je materijal za patohistološku (PH) analizu. Anali- Uvod/Cilj. Cerebrovaskularne bolesti posle malignih i zirani su sledeći parametri : površina plaka, sastav plaka, kardiovaskularnih oboljenja najčešći su uzrok mortaliteta u stepen stenoze ekstrakranijalnog dela karotidne arterije i po- svetu. Zbog toga, pravovremena i tačna dijagnostika obo- stojanje intraplakalne hemoragije. Rezultati. Rezultati CDU ljenja na ekstrakranijalnom segmentu karotidnih arterija, kao i MSCTA upoređeni su međusobno, a zatim i sa intraopera- jednog od osnovnih činilaca u nastanku cerebrovaskularnih tivnim nalazom. Utvrđeno je da je MSCTA senzitivnija ne- bolesti, od velikog je značaja. Cilj ove studije bio je da se go CDU u vizulizaciji površine plaka (kod glatkih plakova uporede rezultati kolor dopler ultrasonografije (CDU) i vi- CDU 89% : MSCTA 97%; kod plakova neravne površine šeslojne kompjuterizovane tomografske angiografije CDU 75% : MSCTA 87%; kod ulkusa CDU 54% : MSCTA (MSCTA) u određivanju postojanja morfoloških i funkcio- 87%). U odnosu na sastav plaka MSCTA je senzitivnija u nalnih poremećaja na ekstrakranijalnom segmentu karotid- odnosu na CDU (mešoviti plak CDU 66% : MSCTA 70%; nih arterija. Metode. Studija je obuhvatala 75 bolesnika korelacija sa PH nalazom CDU 94% : MSCTA 96%), dok kod kojih je pregledano 150 karotidnih arterija, od januara su u odnosu na lokalizaciju plaka (CDU 63% : MSCTA 2008. do aprila 2009. Bolesnicima je prvo urađen CDU i 65%) senzitivnost i specifičnost obe metode približno isti. Correspondence to: Viktorija Vučaj-Ćirilović, Clinical Center of Vojvodina, Radiology Department, Hajduk Veljkova Str. 1–7, 21 000 Novi Sad, Serbia. Phone: +381 21 520 577, +381 63 516 000. E-mail: [email protected] Strana 424 VOJNOSANITETSKI PREGLED Volumen 68, Broj 5 Ne postoji statistički značajna razlika između metoda u od- i činjenice da nema štetnog efekta (visoke doze zračenja) u nosu na postojanje stepena stenoze ekstrakranijalnog dela odnosu na MSCTA, CDU treba da predstavlja inicijalnu karotidne arterije (CDU 96% : MSCTA 98%). Zaključak. metodu u dijagnostičkom algoritmu karotidnih arterija. Aterosklerotska bolest karotidnih arterija javlja se kod bole- snika srednjeg i starijeg životnog doba, često udružena sa Ključne reči: faktorima rizika. Senzitivnost i specifičnost CDU i MSCTA ultrasonografija, dopler, kolor; angiografija mozga; a. u proceni sastava plaka, stepena stenoze i lokalizacije plaka carotis, bolesti; a carotis, stenoza; tomografija, karotidnih arterija približno je ista. Zbog dobijenih rezultata kompjuterizovana, rendgenska. Introduction 2008 – May 2009). There were 24 female and 51 male pa- tients, average age of 63.7 years (ranging from 37 to 86). All Carotid atherosclerotic disease is the cause of cerebro- the patients were referred to examination by the vascular vascular insult in 20% of cases and is often associated with surgeon, with prior MRA findings. atherosclerotic changes in coronary and peripheral vessels. The following symptoms were analyzed: headache, diz- Carotid disease is determined by the level of arterial stenosis, ziness, vertigo, tingling in extremities, sight problems. The morphology of plaque and present ulceration. Ulceration of following risk factors were analyzed: smoking, diabetes, hy- plaque is defined as “intimal defect greater than 1000 µm in pertension, chronic renal insufficiency, hyperlipoproteine- depth covered with necrotic atherosclerotic plaque 1. mia, and associated pathology: cerebrovascular insult, coro- The presence of ulceration in plaque is an important nary infarction and peripheral arterial occlusive disease. risk factor for the occurrance of neurological symptoms, Prior vascular interventions, such as classical surgical inter- while high-grade stenosis associated with ulceration carries venton (TEA), coronary stenting, peripheral stenting (aorto- high risk of developing cerebrovascular insult (CVI). The in- iliac or femoropopliteal segment) or contralateral carotid cidence of ulceration in the carotid artery varies from 14% to stenting were also taken into account. Neurological status in- 68%, and is more often in symptomatic patients. cluded history of prior CVI. Conventional or digital subtractional angiography (DSA) The patients were firstly subjected to CDU, and then to is still considered to be the gold standard for assessing the MSCTA of carotid arteries in the same day, and afterwards level of stenosis, but is somewhat insufficient in determination (with the maximum of two-days delay) operation of the ex- of plaque morphology (sensitivity 46%, specificity 74%) 2. tracranial segment of carotid arteries was performed. After In spite of constant improvement of angiographic tech- thrombendarterectomy, plaque sample was referred to patho- nique, it is sometimes followed by some complications. histological analysis. There are local, general 3 and neurological complications 4. CDU was performed by the experienced radiologist on These complications are the main reason for common use of the GE LOGIC 7 sonographic unit, with a transducer of non-invasive techniques, such as color Doppler ultrasonog- 12MHz. MSCTA was performed by the same radiologist at raphy (CDU), 5, magnetic resonance angiography (MRA) and multislice spiral CT scanner Somatom Sensation 64 Siemens, multislice computed tomographic angiography (MSCTA) in using the bolus-triggering technique. After a short explana- the diagnostics and assessment of carotid disease, as well as tion of examination technique, all the patients signed the in determination of plaque morphology. standard informed consent. No patients presented with con- Stenosis of carotid arteries is one of the main factors in traindications to application of iv contrast agent (all the pa- defining further treatment of a patient 6. Treatment modalities tients had normal values of urea and creatinine, and no his- in a preventive programme of cerebrovascular insult are: ca- tory of allergic reactions to iodine). rotid endarterectomy (CEA), stenting of the carotid artery Intravenous non-iodine contrast agent (iopromid – Ul- (CAS) and medicamentous therapy. The NASCET (North travist 370, Bayer Shering) was applied via cubital vein in American Symptomatic Carotid Endarterectomy Trial) 7, 8 the dose of 100–120 mL, flow 4 mL, programme Carotid and ACAS study (Asymptomatic Carotid Atherosclerotic vascular. The contrast agent was applied using an automatic Group) 7, 9 showed that carotid thrombendarterectomy (CEA) injector,
Load more

Recommended publications
  • Intrarenal Doppler Ultrasonography Reflects Hemodynamics and Predicts
    www.nature.com/scientificreports OPEN Intrarenal Doppler ultrasonography refects hemodynamics and predicts prognosis in patients with heart failure Akiomi Yoshihisa1*, Koichiro Watanabe1, Yu Sato1, Shinji Ishibashi2, Mitsuko Matsuda2, Yukio Yamadera2, Yasuhiro Ichijo1, Tetsuro Yokokawa1, Tomofumi Misaka1, Masayoshi Oikawa1, Atsushi Kobayashi1 & Yasuchika Takeishi1 We aimed to clarify clinical implications of intrarenal hemodynamics assessed by intrarenal Doppler ultrasonography (IRD) and their prognostic impacts in heart failure (HF). We performed a prospective observational study, and examined IRD and measured interlobar renal artery velocity time integral (VTI) and intrarenal venous fow (IRVF) patterns (monophasic or non-monophasic pattern) to assess intrarenal hypoperfusion and congestion in HF patients (n = 341). Seven patients were excluded in VTI analysis due to unclear imaging. The patients were divided into groups based on (A) VTI: high VTI (VTI ≥ 14.0 cm, n = 231) or low VTI (VTI < 14.0 cm, n = 103); and (B) IRVF patterns: monophasic (n = 36) or non-monophasic (n = 305). We compared post-discharge cardiac event rate between the groups, and right-heart catheterization was performed in 166 patients. Cardiac index was lower in low VTI than in high VTI (P = 0.04), and right atrial pressure was higher in monophasic than in non-monophasic (P = 0.03). In the Kaplan–Meier analysis, cardiac event rate was higher in low VTI and monophasic groups (P < 0.01, respectively). In the Cox proportional hazard analysis, the combination of low VTI and a monophasic IRVF pattern was a predictor of cardiac events (P < 0.01). IRD imaging might be associated with cardiac output and right atrial pressure, and prognosis.
    [Show full text]
  • Evaluation of Systolic Murmurs by Doppler Ultrasonography
    Br Heart J: first published as 10.1136/hrt.50.4.337 on 1 October 1983. Downloaded from Br HeartJ 1983; 50: 337-42 Evaluation of systolic murmurs by Doppler ultrasonography ANDREAS HOFFMANN, DIETER BURCKHARDT From the Deparment ofCardiology, University Hospital, Bask., Switzerland SUMMARY Non-invasive continuous and pulsed wave Doppler ultrasonography was performed in 102 consecutive patients with clinically ill defined systolic murmurs to differentiate between flow murmurs, mitral regurgitation, aortic stenosis, and ventricular septal defect, as well as to assess the severity of aortic stenosis. Diagnoses with the Doppler method were based on velocity, direction, and duration of flow signals and were subsequently verified by cardiac catheterisation in all patients. Multiple evaluations were made in 31 patients. Sensitivity and specificity were 0-87 and 0 77 in mitral regurgitation, 0.9 and 1.0 in aortic stenosis, and 1.0 and 1.0 in ventricular septal defect. In 67 patients the estimation of severity of aortic stenosis using the Doppler technique to calculate aortic pressure gradients from maximum flow velocity was significantly correlated with that determined at catheterisation. It is concluded that Doppler ultrasonography is a highly useful technique for the non-invasive evaluation of clinically ill defined systolic murmurs. Systolic murmurs may present difficult diagnostic were studied before catheterisation using non-invasive problems, even to the experienced clinician. This is Doppler ultrasonography.'45 The problems to be especially
    [Show full text]
  • Neurosonology: Transcranial Doppler
    1 Neurosonology: Transcranial Doppler Mark N. Rubin, M.D. Vascular & Hospital Neurology, Neurosonology Assistant Professor of Neurology Email: [email protected] Google Scholar _______________________________ Northwest Neurology https://www.northwestneuro.com/ 2 Contents Transcranial Doppler (TCD) Services and Indications ........................................................................ 3 What is TCD? ............................................................................................................................... 3 What can be accomplished with TCD? .......................................................................................... 3 When is TCD useful? .................................................................................................................... 3 Overview of TCD Ultrasonography ................................................................................................... 4 General Principles of TCD ............................................................................................................. 4 TCD Technique ............................................................................................................................. 7 Patient Safety .............................................................................................................................. 7 Evidence Compendium by Indication ............................................................................................... 8 Cerebrovascular Disease .............................................................................................................
    [Show full text]
  • Venous Thromboembolism According to Age the Impact of an Aging Population
    ORIGINAL INVESTIGATION Venous Thromboembolism According to Age The Impact of an Aging Population Paul D. Stein, MD; Russell D. Hull, MBBS, MSc; Fadi Kayali, MD; William A. Ghali, MD, MPH; Andrew K. Alshab, MD, MPH; Ronald E. Olson, PhD Background: With the aging of the US population, there the use of diagnostic tests over 21 years were markedly is concern that the rate of venous thromboembolism will higher in elderly than in younger patients (PϽ.001). Al- increase, thereby increasing the health burden. In this though the rate of diagnosed DVT in elderly patients strik- study we sought to determine trends in the diagnosis of ingly increased over the past decade (PϽ.001), that of deep venous thrombosis (DVT) and pulmonary embo- PE has been relatively constant. There was a proportion- lism (PE) in the elderly as well as the use of diagnostic ately greater use of venous ultrasonography, ventilation- tests. perfusion lung scanning, and pulmonary angiography in elderly than in younger patients. Methods: Data from the National Hospital Discharge Survey were used. These data are abstracted each year Conclusions: Extensive use of diagnostic tests in el- from a sample of records of patients discharged from non- derly patients in the past decade has resulted in an in- federal short-stay hospitals in the entire United States. creased diagnostic rate for DVT but not PE. The reason Main outcome measures were trends in rates of diagno- for this disparity is uncertain but may reflect early diag- sis of DVT and PE as well as trends in the use of diag- nosis and treatment of DVT.
    [Show full text]
  • Doppler Ultrasonography As a Tool for Ovarian Management
    Anim. Reprod., v.10, n.3, p.215-222, Jul./Sept. 2013 Doppler ultrasonography as a tool for ovarian management J.H.M. Viana1,2,5, E.K.N. Arashiro1,2, L.G.B. Siqueira1, A.M. Ghetti3, V.S. Areas4, C.R.B. Guimarães2, M.P. Palhao2, L.S.A. Camargo1,2, C.A.C. Fernandes2 1Embrapa Dairy Cattle Research Center, Juiz de Fora, MG, Brazil. 2University Jose do Rosario Vellano, Alfenas, MG, Brazil. 3Fluminense Federal University, Niterói, RJ, Brazil. 4Espirito Santo Federal University, Alegre, ES, Brazil. Abstract B-mode ultrasonography, for example, had a central role in the characterization of ovarian follicle dynamics Doppler ultrasonography allows the in different domestic species and in the subsequent characterization and measurement of blood flow, and development of several protocols to control ovarian can be used to indirectly make inference regarding the function for assisted reproductive technologies (ARTs) functionality of different organs, including the ovaries. such as timed artificial insemination, superovulation, Several studies highlighted the importance of an and oocyte pick-up (Adams et al., 2008). The versatility adequate blood flow for follicle development and and the number of potential use have made the B-mode acquisition of ovulatory potential, and for progesterone ultrasound a valuable and widespread adopted tool in secretion by the corpus luteum. Due to some animal reproduction sciences. particularities of the ovarian vascular anatomy, Over the past few decades, various new however, different strategies had to be developed to technologies for image diagnosis with potential use in measure the blood flow detected by Doppler imaging. reproductive medicine emerged, including the Doppler Some of these approaches were successful to ultrasonography (King, 2006).
    [Show full text]
  • Assessment of the Cardiac Functions Using Full Conventional Echocardiography with Tissue Doppler Imaging Before and After Xylazine Sedation in Male Shiba Goats
    animals Article Assessment of the Cardiac Functions Using Full Conventional Echocardiography with Tissue Doppler Imaging before and after Xylazine Sedation in Male Shiba Goats Ahmed S. Mandour 1,2,* , Haney Samir 3,4 , Tomohiko Yoshida 2, Katsuhiro Matsuura 2 , Hend A. Abdelmageed 5,6, Mohamed Elbadawy 7 , Salim Al-Rejaie 8, Hussein M. El-Husseiny 2,9 , Ahmed Elfadadny 10 , Danfu Ma 2 , Ken Takahashi 11, Gen Watanabe 4 and Ryou Tanaka 2,* 1 Department of Animal Medicine (Internal Medicine), Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt 2 Laboratory of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan; [email protected] (T.Y.); [email protected] (K.M.); [email protected] (H.M.E.-H.); [email protected] (D.M.) 3 Department of Theriogenology, Faculty of Veterinary Medicine, Cairo University, Giza 12211, Egypt; [email protected] 4 Laboratory of Veterinary Physiology, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan; [email protected] 5 Laboratory of Veterinary Microbiology, Animal Health Research Institute, Ismailia lab, First District, Ismailia 41522, Egypt; [email protected] 6 Laboratory of Veterinary Microbiology, Cooperative Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan 7 Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, Elqaliobiya 13736, Egypt; [email protected]
    [Show full text]
  • Accuracy of Doppler Ultrasonography in Assessment of Lower Extremity Peripheral Arterial Diseases
    International Journal of Clinical Medicine, 2018, 9, 505-512 http://www.scirp.org/journal/ijcm ISSN Online: 2158-2882 ISSN Print: 2158-284X Accuracy of Doppler Ultrasonography in Assessment of Lower Extremity Peripheral Arterial Diseases Samia Perwaiz Khan, SafiaIzhar Jinnah Medical & Dental College (Medicare Cardiac & General Hospital) Karachi, Pakistan How to cite this paper: Khan, S.P. and Abstract SafiaIzhar (2018) Accuracy of Doppler Ultrasonography in Assessment of Lower Doppler ultrasound scan is a non-invasive, cheap and convenient tool and it Extremity Peripheral Arterial Diseases. complements angiography, Computed tomography angiography (CTA), International Journal of Clinical Medicine, magnetic resonance angiography (MRA) and catheter digital subtraction an- 9, 505-512. https://doi.org/10.4236/ijcm.2018.96043 giography (DSA) in screening, diagnosis, treatment and follow-up of peri- pheral vascular diseases. Symptoms of peripheral vascular diseases are be- Received: April 24, 2018 coming more common due to rise in incidence of diseases and risk factors Accepted: June 10, 2018 Published: June 13, 2018 (diabetes mellitus, dyslipidemias, smoking, sedentary lifestyle). Due to limited availability of highly specific tools such as CT angiography, magnetic reson- Copyright © 2018 by authors and ance angiography (MRA) and DSA (digital subtraction angiography) in many Scientific Research Publishing Inc. developing countries, doppler ultrasound is gaining more importance. Early This work is licensed under the Creative Commons Attribution International determination of peripheral arterial diseases is beneficial in prevention of License (CC BY 4.0). complications as severity increases may cause intermittent claudication, pain, http://creativecommons.org/licenses/by/4.0/ tissue loss, including ulceration and gangrene (as the diseases progresses) and Open Access early management of arteriosclerosis will be beneficial to prevent these com- plications.
    [Show full text]
  • Carotid Doppler Ultrasonography Evaluation in Patients with Stroke
    K. Karthick, J. A. Vasanthakumar. Carotid doppler ultrasonography evaluation in patients with stroke. IAIM, 2018; 5(3): 23- 29. Original Research Article Carotid doppler ultrasonography evaluation in patients with stroke K. Karthick1, J. A. Vasanthakumar2* 1Assistant Professor, 2Associate Professor Department of General Medicine, Government Dharmapuri Medical College, Dharmapuri, India *Corresponding author email: [email protected] International Archives of Integrated Medicine, Vol. 5, Issue 3, March, 2018. Copy right © 2018, IAIM, All Rights Reserved. Available online at http://iaimjournal.com/ ISSN: 2394-0026 (P) ISSN: 2394-0034 (O) Received on: 15-02-2018 Accepted on: 23-02-2018 Source of support: Nil Conflict of interest: None declared. How to cite this article: K. Karthick, J. A. Vasanthakumar. Carotid doppler ultrasonography evaluation in patients with stroke. IAIM, 2018; 5(3): 23-29. Abstract Introduction: Stroke is defined as rapid onset of focal neurological deficit resulting from diseases of cerebral vasculature and its contents. Community surveys in India have shown a crude prevalence rate for hemiplegia in the range of 200 per 100,000 persons, nearly 1.5% of all urban hospital admission, 4.5% of all medical and around 20% of neurological cases. The aim of the study: To determine the usefulness of doing Carotid Doppler Ultrasonography as a screening procedure in predicting the chance of developing stroke in persons having risk factors for stroke. Materials and methods: The study was conducted in Department of Medicine, Government Dharmapuri Medical College, Dharmapuri in December 2017 to January 2018. In this study, patients who were admitted with a history of sudden onset of neurological illness are subjected to CT scan brain.
    [Show full text]
  • Evaluation of Arterial Digital Blood Flow Using Doppler Ultrasonography in Healthy Dairy Cows H
    Müller et al. BMC Veterinary Research (2017) 13:162 DOI 10.1186/s12917-017-1090-8 RESEARCH ARTICLE Open Access Evaluation of arterial digital blood flow using Doppler ultrasonography in healthy dairy cows H. Müller1* , M. Heinrich1, N. Mielenz2, S. Reese3, A. Steiner4 and A. Starke1 Abstract Background: Local circulatory disturbances have been implicated in the development of foot disorders in cattle. The goals of this study were to evaluate the suitability of the interdigital artery in the pastern region in both hind limbs using pulsed-wave (PW) Doppler ultrasonography and to investigate quantitative arterial blood flow variables at that site in dairy cows. An Esaote MyLabOne ultrasound machine with a 10-MHz linear transducer was used to assess blood flow in the interdigital artery in the pastern region in both hind limbs of 22 healthy German Holstein cows. The cows originated from three commercial farms and were restrained in a standing hoof trimming chute without sedation. Results: A PW Doppler signal suitable for analysis was obtained in 17 of 22 cows. The blood flow profiles were categorised into four curve types, and the following quantitative variables were measured in three uniform cardiac cycles: vessel diameter, pulse rate, maximum systolic velocity, maximum diastolic velocity, end-diastolic velocity, reverse velocity, maximum time-averaged mean velocity, blood flow rate, resistance index and persistence index. The measurements did not differ among cows from the three farms. Maximum systolic velocity, vessel diameter and pulse rate did not differ but other variables differed significantly among blood flow profiles. Conclusions: Differences in weight-bearing are thought to be responsible for the normal variability of blood flow profiles in healthy cows.
    [Show full text]
  • Evaluation of Portal Blood Flow in Schistosomal Patients: a Comparative Study Between Magnetic Resonance Imaging and Doppler Ultrasonography
    Artigo Original • Original ArticleAvaliação do volume de fluxo portal em pacientes esquistossomóticos Avaliação do volume de fluxo portal em pacientes esquistossomóticos: estudo comparativo entre ressonância magnética e ultrassom Doppler* Evaluation of portal blood flow in schistosomal patients: a comparative study between magnetic resonance imaging and Doppler ultrasonography Alberto Ribeiro de Souza Leão1, Danilo Moulin Sales1, José Eduardo Mourão Santos2, Edson Nakano1, David Carlos Shigueoka3, Giuseppe D’Ippolito4 Resumo OBJETIVO: Avaliar a concordância entre o ultrassom Doppler e a ressonância magnética e a reprodutibilidade interobservador desses métodos na quantificação do volume de fluxo portal em indivíduos esquistossomó- ticos. MATERIAIS E MÉTODOS: Foi realizado estudo transversal, observacional e autopareado, avaliando 21 pacientes portadores de esquistossomose hepatoesplênica submetidos a mensuração do fluxo portal por meio de ressonância magnética (utilizando-se a técnica phase-contrast) e ultrassom Doppler. RESULTADOS: Observou-se baixa concordância entre os métodos (coeficiente de correlação intraclasse: 34,5% [IC 95%]). A reprodutibilidade interobservador na avaliação pela ressonância magnética (coeficiente de correlação in- traclasse: 99,2% [IC 95%] / coeficiente de correlação de Pearson: 99,2% / média do fluxo portal = 0,806) e pelo ultrassom Doppler (coeficiente de correlação intraclasse: 80,6% a 93,0% [IC 95%] / coeficiente de correlação de Pearson: 81,6% a 92,7% / média do fluxo portal = 0,954, 0,758 e 0,749) foi excelente. CONCLUSÃO: Há uma baixa concordância entre o ultrassom Doppler e a ressonância magnética na mensu- ração do volume de fluxo na veia porta. A ressonância magnética e o ultrassom Doppler são métodos repro- dutíveis na quantificação do fluxo portal em pacientes portadores de hipertensão porta de origem esquistos- somótica, apresentando boa concordância interobservador.
    [Show full text]
  • Color Doppler Sonography of an Aneurysm of the Middle Cerebral Artery in a Child
    N.C. Chiu and E.Y. Shen Color Doppler Sonography of an Aneurysm of the Middle Cerebral Artery in a Child Nan-Chang Chiu1,2 and Ein-Yiao Shen1,3 A 4-month-old boy had a cerebral aneurysm detected on color Doppler sonography as a colorful cystic lesion at the junction of the right frontal and parietal lobes. Three-dimensional color Doppler sonography after the first operation revealed residual anomalous vessels related to the right middle cerebral artery. Blood flow in the feeding vessel was faster, but the resistance index and pulsatility index were lower than in the contralateral vessel. This case demonstrates that Doppler sonography is a valuable diagnostic technique for detecting intracranial aneurysms and for following any associated anomalies. (J Med Ultrasound 2003;11:18–21) KEY WORDS: • aneurysm • power Doppler ultrasonography • three-dimensional ultrasonography INTRODUCTION Doppler cerebral sonography (5.0 MHz sector scan, SSA-260A, Toshiba, Tokyo, Japan) revealed Doppler sonography allows visualization of a colorful cystic lesion with a separation zone at intracranial aneurysms and their hemodynamic the junction of the right frontal and parietal lobes changes [1, 2]. Color power Doppler and three- (Fig. 1A). Brain computed tomography (CT) scan dimensional sonography have an advantage over showed contrast medium within the cyst and conventional Doppler imaging in that cerebral hydrocephalus with intraventricular blood. vascular anomalies can be seen in greater detail [3, A craniotomy was performed and the aneurysm 4]. We report a child with an aneurysm of the was clipped. Pathology showed tortuous dilated middle cerebral artery (MCA) detected by conven- vessels with a thin, loose fibrous wall consistent tional Doppler sonography.
    [Show full text]
  • Ultrasound Examination of the Extracranial Cerebrovascular System
    extracranial.qxp_1115 6/29/16 3:54 PM Page 1 AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Extracranial Cerebrovascular System Parameter developed in collaboration with the American College of Radiology, the Society for Pediatric Radiology, and the Society of Radiologists in Ultrasound. © 2016 by the American Institute of Ultrasound in Medicine extracranial.qxp_1115 6/29/16 3:54 PM Page 2 The American Institute of Ultrasound in Medicine (AIUM) is a multidis- ciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of parameters, and accreditation. To promote this mission, the AIUM is pleased to publish, in conjunction with the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Radiologists in Ultrasound (SRU), this AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Extracranial Cerebrovascular System. We are indebted to the many volunteers who contributed their time, knowl- edge, and energy to bringing this document to completion. The AIUM represents the entire range of clinical and basic science interests in medical diagnostic ultrasound, and, with hundreds of volunteers, the AIUM has promoted the safe and effective use of ultra- sound in clinical medicine for more than 50 years. This document and others like it will continue to advance this mission. Practice parameters of the AIUM are intended to provide the medical ultrasound community with parameters for the performance and recording of high-quality ultrasound examinations. The parameters reflect what the AIUM considers the minimum criteria for a complete examination in each area but are not intended to establish a legal stan- dard of care.
    [Show full text]