Real-time Three-Dimensional Color Doppler Flow Imaging： An Improved Technique for Quantitative Analysis of Aortic Regurgitation

The recently introduced real-time three-dimensional color Doppler flow imaging （RT-3D CDFI） technique provides a quick and accurate calculation of regurgitant jet volume （RJV） and fraction. In order to evaluate RT-3D CDFI in the noninvasive assessment of aortic RJV and regurgitant jet fraction （RJF） in patients with isolated aortic regurgitation, real-time three-dimensional echocardiographic studies were performed on 23 patients with isolated aortic regurgitation to obtain LV end-diastolic volumes （LVEDV）, end-systolic volumes （LVESV） and RJV, and then RJF could be calculated. The regurgitant volume （RV） and regurgitant fraction （RF） calculated by two-dimensional pulsed Doppler （2D-PD） method served as reference values. The results showed that aortic RJV measured by the RT-3D CDFI method showed a good correlation with the 2D-PD measurements （r= 0.93, Y=0.89X＋ 3.9, SEE= 8.6 mL, P〈0.001 ）; the mean （SD） difference between the two methods was - 1.5 （9.8） mL. % RJF estimated by the RT-3D CDFI method was also correlated well with the values obtained by the 2D-PD method （r=0.88, Y=0.71X＋ 14.8, SEE= 6.4 %, P〈0. 001）; the mean （SD） difference between the two methods was -1.2 （7.9） %. It was suggested that the newly developed RT-3D CDFI technique was feasible in the majority of patients. In patients with eccentric aortic regurgitation, this new modality provides additional information to that obtained from the two-dimensional examination, which overcomes the inherent limitations of two-dimensional echocardiography by depicting the full extent of the jet trajectory. In addition, the RT-3D CDFI method is quick and accurate in calculating RJV and RJF.

Hemodynamic Changes on Color Doppler Flow Imaging and Intravenous Contrast-enhanced Ultrasound for Assessing Transplanted Liver and Early Diagnosis of Complications

The value of color Doppler flow imaging （CDFI） and intravenous contrast-enhanced ultrasound （CEUS） for assessing the transplanted liver and early diagnosing complications by examining hemodynamic changes was discussed. Seventy-five patients with orthotopic liver transplantation （OLT） underwent CDFI. The following parameters were measured： peak systolic velocity （PS）, resistance index （RI） and Doppler perfusion index （DPI） of the hepatic artery （HA）, time average velocity （TAV） of portal vein （PV） and velocity of hepatic vein （HV） in different stages postoperation, And 11 patients of them received CEUS. Thirty healthy subjects were enrolled as controls, The results showed that： （1） In 23 patients without obvious complications, TAV of PV within 15 days post-operation was significantly higher than in controls （P〈0.05）, PS and DPI of HA within 7 days postoperation were lower, but RI was higher than in controls （P〈0.05）; （2） When the hepatic artery thrombosis （HAT） occurred, PS and DPI of HA were obviously decreased, but TAV of PV significantly increased like a high saw-tooth wave; （3） While rejection occurred, both TAV of PV and PS of HA were decreased with the increase in RI of HA, and the triphasic wave of HV disappeared and displayed as saw-tooth wave; （4） The incidence of biliary complications in liver transplantation was increased when DPI was reduced; （5） Seven cases of hepatic carcinoma relapse after OLT demonstrated hyperecho in the arterial phase and hypoecho in the portal and later phase on CEUS; （6） In 2 cases of HA thrombus, there was no visualized enhancement in arterial phase of CEUS, but enhancement during the portal vein and parenchymal phase. It was concluded that the hemodynamic changes of PV, HA and HV in the transplanted liver are valuable for assessing the transplanted liver and early diagnosing complications on CDFI and CEUS.

Left Coronary Artery Fistula Identified by Color Doppler Flow Imaging

Coronary artery fistula (CAF) is an abnormal communication between a coronary artery and a cardiac chamber, great vessel,or other vascular structures. The presence of the fistula is usually identified by angiography. In this paper, the diagnosis of left coronary artery-right ventricle fistula was made by color Doppler before angiography? and it was confirmed by surgery.Color Doppler flow imaging is a noninvasive method which can reveal the proximal dilatation, the course and the draining site of CAF.

Thrombelastography and color Doppler flow imaging in the perioperative period after closed lower limb fracture

Objective To observe the changes of thrombelastography (TEG) and color Doppler flow imaging (CDFI) in the perioperative period after closed lower limb fracture.Methods Fasting venous blood samples in the morning from 11 healthy adults were used

Design of axial flaps with color Doppler flow imaging technique for repairing deep wounds of heels

To report the methods and effect of axial pattern flap on lower limb in repairing deep wounds of heels by using color Doppler flow imaging (CDFI) technique so as to solve the ever before problems that the vessel can not be displayed in designing axial flap.Methods Suitable axial flaps on lower limbs were selected according to the character of the wounds.There were 25 flaps including 10 cases of the distal-based sural neurovascular flap,nine medial sole flap and six medial leg flap.All the axial pattern flaps were designed on the basis of traditional design ways before operation;then,CDFI appliance with high resolution was used to examine the starting spot,exterior diameter,trail and length of the flap’s major artery.The flaps were redesigned according to the results of CDFI and transferred to cover the wounds.In the meantime,both the results of operation and examination were compared.Results The major artery’s starting spot,exterior diameter,trail and anatomic layers were displayed clearly,in consistency with the results of operation.The flaps survived completely and recovered well,with perfect appearance,color and arthral function.Conclusion CDFI is a simple,macroscopic and atraumatic method for designing the axial pattern flap on lower limb,can provide more scientific and accurate evidence for preoperative determination of flap transplantation and is worthy of clinical application.10 refs,4 figs,2 tabs.

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

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 E1 （10 μg）, 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.

Value of Acceleration Flow in the Left Anterior Descending Coronary Artery for the Detection of Coronary Artery Stenosis by Transthoracic Coronary Color Doppler Echocardiography

Summary： Whether the localized flow acceleration occurs in the resting stenotie left anterior descending coronary artery was explored and its value for detection of coronary stenosis estimated. Blood flow in the left anterior descending coronary arteries in 45 patients was detected by transthoratio color Doppler echocardiograph and multipoint pulse Doppler spectrums were recorded in the same segment. The ratio of the maximal peak diastolic velocity to the minimal peak diastolic velocity was calculated. The ratio ≥1.5 was the cutoff value for the presence of localized acceleration flow. There were 23 patients with localized acceleration flow examined by eehoeardiography. Twenty of them were found to have luminal diameter stenosis （60%-98%） in the left anterior descending coronary arteries by coronary angiography and 3 patients were normal. There were 22 patients without localized acceleration flow examined by eehoeardiography. Eighteen of them had no or %60 stenosis. Four patients had serious stenosis （≥95%） or occluded segments in the left anterior descending coronary arteries on coronary angiography. The ratio of the maximal peak diastolic velocity to the minimal peak diastolic velocity was significantly higher in patients with left anterior descending coronary artery stenosis than that in those without stenosis （1.9±0.3 vs 1.3±0.2, P〈0.01） and it correlated significantly with left anterior descending coronary artery stenosis （r=0.77, P〈0.01）. The specificity by using the ratio≥1. 5 for stenosis detection was 85.7% （18/ 21）, and the sensitivity was 83.3% （20/24）. This study demonstrated that local blood flow velocity was increased in the resting stenotie left anterior descending coronary artery. Transthoraeie color Doppler eehoeardiography is a reliable noninvasive method to detect localized acceleration flow in the left anterior descending coronary artery stenosis and it is useful in the noninvasive diagnosis of stenosis in the left anterior descending coronary artery.

PRELIMINARY APPLICATION OF COLOR DOPPLER FLOW IMAGING IN THE LOCALIZATION OF PARATHYROID ADENOMAS

From December 1991 to April 1993, we performed color Doppler flow imaging (CDFI) in 11 patients with parathyroid adenoma, and all cases were confirmed by operation and pathology. In all the parathyroid adenomas,vessels were clearly revealed at the periphery of the upper pole and/or anterior periphery, where arterial signals were elicited. These arteries had branches into the adenomas and originated from inferior thyroid arteries on the same side in most cases. The internal flow signals were increased markedly as compared to normal thyroid, and high-velocity arterial signals were detected. Because of the thyroid' s rich blood supply and landmark peripheral vessels, CDFI can distinguish parathyroid foci from thyroid nodules, lymph nodes, and normal tissues and provide a sound basis for the diagnosis of small parathyroid foci.

Measurements Of Cerebral Blood Flow in Postasphyxiated Newborns by Color Doppler Imaging（CDI）

Cerebral blood flow of 10 asphyxiated term newborns was continuously measured during the first 7 days of life and compared with that of 10 normal term infants by CDI. Frequency spectrum and blood flow variables in the anterior, middle and posterior cerebral arteries were studied. The results showed evidently lower systolic amplitude in patients than that in normal subjects. End diastolic amplitude was zero in part of vessels, and values of bloed flow variables were all lower in day 1 of the life as compared with the control groups. Frequency spectrum recovered to normal patterns in 9 survived infants in day 2. but blood flow variables recovered to normal by day 7. Values of resistance index (RI) rose to 1 in some vessels of moderate hypoxic ischemic encephalopathy (HIE) infants and stayed at 1 in the severe HIE infants. It is concluded that low CBF plays a key role in brain damage of post-asphyxiated newborns and RI may be an important parameter in the evaluation prognosis.

Graves' Disease Thyroid Color-Flow Doppler Ultrasonography Assessment: Review Article

Graves’ disease, as known today, is an autoimmune, diffuse, chronic disease of thyroid gland, as described by Robert Graves in 1835. It presents genetic predisposition and unknown etiology evidence, which is influenced in its development by several factors, including environment (dietary iodine intake, stress, drugs and infections). The disease is characterized by one or more changes: hyperthyroidism, goiter, ophthalmopathy, skin changes and pretibial myxedema, around 5% less common, and other symptoms 90% to 95%. One of the most relevant clinical practice aspects in Graves’ disease patients management is to distinguish Graves’ disease in initial phase, from other types of destructive thyrotoxicosis, in addition to evaluate therapeutic methods and efficient follow up, as well as predict early recurrence or remission of disease. Scintigraphy with pertechnetate (99 mTc) and TSH levels dosage are considered the choice for this purpose. However, they present some technical difficulties, as they are not widely available and have contraindications. In this scenario, thyroid color-flow doppler ultrasonography (US Doppler) presents a viable alternative, as a widely available, low cost, non-invasive and radiation free method, providing initial diagnosis and patients with Graves’ disease follow up. In adittion, this method is used in differential diagnosis with other causes of thyrotoxicosis in the early stage.

Measurement of Liver Size and Intrahepatic Blood Flow of Red-eared Turtles by Color Doppler Ultrasound

In the study, a total of 20 red-eared turtles （ half male and half female） were selected to conduct the measurement of liver size and intrahepatic blood flow of red-eared turtles by color Doppler ultrasound. The results showed that the fight hepatic lobe could be scanned through the right carotid anterior acoustic win- dow, and the left hepatic lobe could be scanned through the left carotid anterior acoustic window, but the vision would be obstructed by the air in trachea. The liver could also be scanned through the left femoral anterior acoustic window and the fight femoral anterior acoustic window when filling of bladder was good. The correla- tion regression analysis suggested that estimated values of liver showed no linear relationship with weight, the longest back curve and the widest back curve. Through the study, the normal indicators for ultrasound examination of red-eared turtle liver were established, in order to provide a reference for examination of turtle liver.

The Study of Ovarian Artery Hemodynamics in Patients with Infertility by Color Doppler Energy

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.

CHARACTERISTICS OF TWO－DIMENSIONAL AND COLOR DOPPLER ULTRASONOGRAPHY IN GRAVES＇DISEASE

Color Doppler flow imaging(CDFI) was performed in 24 patients with Graves' disease and the results were compared with those from 8 patients with Hashimoto's disease, 6 patients with simple diffuse goiter, and 15 normal volunteers. All cases were confirmed by clinical, laboratory tests or pathology. CDFI of Graves' disease showed diffuse or localized hypoechoes within the thyroid glands, rich flow signals in the hypoechoes, accelerated flow velocity, and decreased resistance in the superior thyroid arteries(STA) and arteries within the glands. These appearances were characteristic as compared with the controls. The rate of flow in STA of Graves' disease patients was 8 to 10 times higher than that in the normal volunteers. This study demonstrates that CDFI is convenient and efficient as compared with isotope scan and some other laboratory tests, and can be widely used in the diagnosis of Graves' disase.

Application of Color Doppler Ultrasonic Examination in Deep Vein Valvular Incompetence in Lower Limbs

By use of color Doppler Flow Imaging (CDFI), the morphologic and hemodynamic parameters such as the diameters of femoral and popliteal veins,blood flow velocity and the reflux 0f valve area were examined in lower extremity deep valvular incompetence (DVI) and normal control gr0ups. The purpose was to evaluate the value of CDFI in the diagnosis of DVI. The results demonstrated that the parameters between the two groups had a very significant difference (P<0. 001), indicating that the CDFI is non-invasive, cost-effective and safe and it might serve as a practical tool in the diagnosis of lower extremity deep va1vular incompetence.

TRANSVAGINAL COLOR DOPPLER STUDY OF UTEROPLACENTAL CIRCULATION IN NORMAL EARLY PREGNANCY

A cross sectional transvaginal color Doppler study of the uteroplacental circulation was performed on 105 pregnant women with normal intrauterine pregnancy. Gestational age was ranged from 4 to 12 weeks. The blood flow velocity waveforms were obtained from four separate parts of the uteroplacental circulation: uterine, arcuate, radial, and spiral arteries. The resistance index (RI) and peak systolic velocity (PSV) were analyzed. The RI significantly decreased and PSV increased with advancing gestation in uterine artery and its branches (P<0 05). The RI gradully decreased from uterine artery through arcuate, radial to spiral arteries (P<0 05). At the same time, the PSV decreased from uterine artery then arcuate to radial artery, but PSV in spiral arteries were higher than that in radial artery (P<0 05). The results showed that transvaginal color Dopper ultrasonography was a simple, reliable method to assess the uteroplacental circulation in the early pregnancy; the detection of PSV was useful parameter for better understanding of physiological and pathophysiological hemodynamic changes as well as RI.

彩色多普勒超声血流评分对附件扭转患者卵巢活性的预测价值

目的研究卵巢彩色多普勒血流成像(CDFI)评分预测附件扭转患者卵巢活性的价值。方法选取经手术证实的32例附件扭转患者,根据卵巢血流信号进行评分,将其与术中卵巢活性进行对比分析。结果卵巢CDFI评分推测卵巢存活的灵敏度为90%,特异度为81.82%,阳性预测值为69.23%,阴性预测值为94.74%,卵巢CDFI血流存在与手术中卵巢存活的一致性较好,Kappa值为0.664。结论CDFI能够对附件扭转者卵巢活性进行预估,卵巢血流评分可为临床提供较为可靠、有效的影像学依据。

COLOR FLOW IMAGING OF HEPATIC CARCINOMA

Color flow imaging(CFI)ultrasound technique can discover the tumor vascularity and superimposed it to convontional B-mode ultrasonogram in real-time. The flow velocity on spectral Doppler sonogram can be measured by setting the sample volume to any selected site.One hundred and thirty-six patients with solid hepatic space-occupied lesions had been admitted and 113 cases were confirmed by operation and pathology,23 patients were strongly suspected by hepatic angiography (HAA).Ninety nine patients with 109 nodules were finally diagnosed as hepatic cellular carcinoma(HCC).According to color flow distribution pattern,3 kinds of color configuation had been nominated.Tumor vascularity discovered by CFI,especially the arterial blood flow was easy to be recognized,and its emerge rate was quite different between HCC group(94.5%)and hemangioma(HCH)group(17.07%)(P<0.01).Spectral Doppler studies were also carried out in these cases and the detectability of arterial flow in HCC group(95.41%)was much higher than that to HCH group (21. 95%) (P<0. 005).Resistant index(RI)and pulsatile index(PI)could be used to differentiate HCC (>0. 50 and >0.80 respectively)from HCH (P<0.001 and P<0.001 respectively).Arterial-portal(A-P) shunt could also be detected by CFI and spectral Doppler(mostly its Vmax>0.6m/s).The detection rate of A-P shunt was 64% in HCC group,but no case could be detected in HCH group.

CDFI血流信号分级、抗CCP抗体、G6PI、RF对类风湿性关节炎的诊断价值

目的分析彩色多普勒血流显像(CDFI)血流信号分级、抗环瓜氨酸肽抗体(CCP)、葡萄糖6磷酸异构酶(G6PI)、类风湿因子(RF)对类风湿性关节炎(RA)的诊断价值。方法回顾性选取2022年4月至2023年10月新疆医科大学附属中医医院收治的100例RA患者纳入观察组,根据病情分为RA活动期组(n=50)和RA非活动期组(n=50);依据血流信号CDFI分级分为0~1级组(n=20)、2级组(n=17)、3级组(n=13)。选取同期本院收治的100例其他自身免疫性疾病患者纳入对照组。比较观察组、对照组一般临床资料(性别、病程、年龄、RA家族史、体重指数、吸烟史、饮酒史、居住地、职业等),比较不同活动期患者抗CCP抗体、G6PI及RF水平;比较不同血流信号分级组患者抗CCP抗体、G6PI及RF水平;采用受试者工作特征(ROC)曲线评估CDFI血流信号分级、抗CCP抗体、G6PI、RF联合检测对RA的诊断价值。结果两组患者性别构成比、病程、年龄、RA家族史、体重指数、吸烟史、饮酒史、居住地、职业比较,差异均无统计学意义(P>0.05);观察组患者抗CCP抗体、G6PI及RF水平均高于对照组,差异均有统计学意义(P<0.05)。RA活动期组患者抗CCP抗体、G6PI及RF水平均高于RA非活动期组患者,差异均有统计学意义(P<0.05)。血流信号3级组患者抗CCP抗体、G6PI及RF水平均高于血流信号0-1级组、2级组患者,差异均有统计学意义(P<0.05)。CDFI血流信号分级、抗CCP抗体、G6PI、RF单独检测RA的敏感度分别为79.57%、86.45%、82.14%、77.89%,特异度分别为83.89%、79.28%、83.67%、84.15%,AUC分别为0.855(0.804~0.907)、0.940(905~0.976)、0.893(0.852~0.935)、0.800(0.736~0.864),CDFI血流信号分级、抗CCP抗体、G6PI、RF联合检测RA的敏感度为89.36%,特异度为77.24%,AUC为0.957(0.933~0.980)。结论RA患者血清CCP抗体、G6PI、RF水平升高,随着CDFI血流信号分级增大,升高愈加明显,CDFI血流信号分级、抗CCP抗体、G6PI、RF联合检测RA诊断价值较高,对判断RA进展具有意义。

二维超声联合微血管血流成像对睾丸结核的诊断价值

目的:探讨二维超声联合微血管血流成像(MV-flow)对睾丸结核的诊断价值。方法:选择2023年1月至12月在郑州大学第一附属医院因阴囊疼痛、坠胀,或伴有阴囊肿块就诊,疑似睾丸结核的91例患者为研究对象。均行二维超声检查、彩色多普勒血流显像(CDFI)和MV-flow。以病理结果为金标准,比较二维超声联合MV-flow及二维超声联合CDFI诊断睾丸结核的效能,同时计算血流像素占比。另外选取20例疑似睾丸结核患者,通过MV-flow获取血管指数(VI),采用同类相关系数(ICC)评估MV-flow检测结果的一致性。结果:91例患者中共有80例病理确诊为睾丸结核。二维超声联合MV-flow诊断睾丸结核的敏感度、特异度、准确度分别为96.3%、54.6%和91.2%,高于二维超声联合CDFI(87.5%、18.2%、79.1%)。MV-flow睾丸内血流像素占比高于CDFI[(2.13±0.81)%vs(1.86±0.70)%,P=0.360]。VI在观察者内和观察者间的一致性良好[ICC(95%CI)分别为0.874(0.683~0.950)、0.945(0.860~0.978)]。结论:相比二维超声联合CDFI,二维超声联合MV-flow对睾丸结核的诊断效能更高。

二维斑点追踪技术在评估冠心病患者左心室收缩与舒张功能中的应用价值

目的探讨二维斑点追踪技术在评估老年冠心病患者左心室收缩与舒张功能中的应用价值。方法对60例老年冠心病患者(研究组)和60名健康老年人(对照组),应用彩色多普勒超声诊断仪进行左心室功能检查。比较两组血压、生化指标(三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆固醇、糖化血红蛋白)及常规超声参数、二维斑点超声应变参数、血流频谱测量超声参数。结果研究组受试者收缩压、舒张压及三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆固醇、糖化血红蛋白水平均高于对照组(P<0.01)。两组受试者收缩末期和舒张末期的左室内径、室间隔壁厚度、左室前/后/下壁厚度比较,差异无统计学意义(P>0.05)。研究组受试者左室舒张充盈末流速峰值/左室收缩末流速峰值低于对照组(P<0.05);两组受试者左室射血分数、左室舒张充盈末流速峰值、左室收缩末流速峰值比较,差异无统计学意义(P>0.05)。研究组受试者舒张期和收缩期的左心室前壁、后壁、下壁、室间隔的纵向、径向、周向峰值绝对值均低于对照组(P<0.01)。结论二维斑点追踪技术的抗干扰能力较强,二维斑点超声应变参数能有效反映冠心病患者左室收缩、舒张情况,具有较高的应用价值。