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.

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.

Color Doppler Imaging in the Diagnosis and Follow-up of Carotid Cavernous Sinus Fistulas

This report describes color doppler imaging (CDI) in theevaluation and follow-up of nine patients with carotid cavernous sinusfistulas.The orbits and carotid arteries were examined with CDI.In allcases,the diagnosis was confirmed by angiography.CDI clearlydemonstrated the dilated superior ophthalmic veins (SOVs) with retrogradeflow and low resistance arterial doppler waveform in all nine patients (10eyes).After the study of quantitative hemodynamics,we found that directcarotid cavernous sinus fistulas s...

Role of color Doppler flow imaging in applicable anatomy of spleen vessels

AIM： To explore the role of color Doppler flow imaging （CDFI） in visualization of spleen vessels and to define its value for spleen micro-invasive operation. METHODS： A total of 36 patients requiring laparoscopic splenectomy （LS） for various hematopathies and autoimmune diseases were randomly selected from April 2005 to May 2008. Anatomic types of spleen pedicle, adjacent relations between spleen vessels and pancreas, diameters of spleen artery and vein were detected and recorded by preoperative CDFI. Different operative procedures were performed according to different anatomic frameworks. The parameters were recorded by telerecording during LS and compared with those by preoperative CDFI using Chi-square test. RESULTS： Two anatomic types of spleen pedicle and four different adjacent relations between spleen vessels and pancreas were detected by CDFI. The diameters of spleen artery and vein detected by CDFI were 0.46 ± 0.09 cm and 0.85 ± 0.35 cm, respectively. There was no statistical difference between the parameters recorded by CDFI and by telerecording （X^2 = 0.250, 0.677, P 〉 0.05）. LS was successfully performed following the anatomic information provided by preoperative CDFI.CONCLUSION： Different anatomic frameworks of spleen vessels can be provided by preoperative CDFI, which instructs micro-invasive operation of spleen and increase the safety of operation.

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.

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.

FEASIBILITY STUDY OF AN ULTRASOUND CONTRAST AGENT(LEVOVIST) IN COLOR DOPPLER IMAGING OF LIVER NEOPLASMS

The purpose of this study was to determine the efficacy of using an ultrasound contrast agent(levovist)to enhance the color Doppler imaging of liver neoplasms.Thirty patients with hepatic tumors were enrolled in this study.After intravenous administration of levovist,the color Doppler signals of normal hepatic vessels were enhanced.In various hepatic tumors,the different patterns of tumor vascularity were observed,which had not been demonstrated in conventional non contrast color Doppler imaging.In 11 of 16 patients with hepatocarcinoma,additional color Doppler signals were observed in the central part of the tumors.On the contrary,3 patients with metastatic liver lesions the enhanced color Doppler signals appear only at the peripheral of tumors.A typical rim like color enhancement was seen in 2 of the 3 cases.In six patients with hepatic hemangiomas contrast enhanced color Doppler imaging demonstrated the blood vessels at the margin of the neoplasms.Contrast enhanced color Doppler imaging improves the visualization of the hepatic neoplasm vascularity.This technique holds great promise for detecting small liver tumors and differentiating hepatic neoplasms.

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.

Color Doppler Imaging in the Study of Retrobulbar Hemodynamic Changes of Primary Angle-closure Glaucoma

Purpose: To investigate the hemodynamic changes of ophthalmic and central retinal artery (OA,CRA) in Primary Angle-closure Glaucoma (PACG) and the effects of intraocular pressure (TOP) on the retrobulbar hemodynamics.Methods: The hemodynamic changes of OA, CRA in PACG were explored with color Doppler imaging (CDI) technique. Peak systolic blood flow velocity (PSV), end-diastolic blood flow velocity (EDV),pulsatile and resistive indices (PI,RI) were recorded and compared with those of the normal subjects. There were 20 patients (40 eyes) with PACG who were divided into two groups according to their IOP levels; ocular hypertension (15 eyes) and normal tension (25 eyes) .Results : Compared with the normal subjects, the hypertension group of PACG showed significant reduction in the EDV and increases in PI, RI of CRA; normal tension group of PACG also showed remarkable increase in RI of CRA. The ocular hypertension was significantly correlated with the RI and not with the EDV by the analysis of multiple

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.

Application of superb microvascular imaging in focal liver lesions

AIM To explore the ability of superb microvascular imaging(SMI) in differential diagnosis of focal liver lesions(FLLs) and to compare SMI morphology findings to those of color Doppler ultrasound and enhanced imaging.METHODS Twenty-four patients with 31 FLLs were included in our study,with diagnoses of hemangioma(HE)(n = 17),hepatocellular carcinoma(HCC)(n = 5),metastatic lesions(n = 5),primary hepatic lymphoma(n = 1),focal nodular hyperplasia(FNH)(n = 2),and adenoma(n = 1). Nine lesions were pathologically diagnosed,and 22 lesions were radiologically confirmed,all of which were evaluated by at least two types of enhanced imaging techniques. All patients had undergone SMI. Patients were divided into subgroups based on pathological and radiological diagnoses to analyze SMI manifestations. We also compared the SMI manifestations of the most common malignant FLLs(HCCs and metastatic lesions) with those of the most common benign FLLs(HEs).RESULTS HEs were classified into three SMI subgroups: diffuse dot-like type(n = 6),strip rim type(n = 8),and nodular rim type(n = 3). The sizes of the three types of HEs were significantly different(P = 0.00,< 0.05). HCCs were classified into two subgroups: diffuse honeycomb type(n = 2) and non-specific type(n = 3). Four of the metastatic lesions were the strip rim type,and the other metastatic lesion was the thick rim type,which is the same as that of lymphoma. FNH was described as a spoke-wheel type,and adenoma as a diffuse honeycomb type. The SMI types of HCCs and metastatic lesions were significantly different from those of HEs(P = 0.048,< 0.05).CONCLUSION SMI technology enables microvascular evaluation of FLLs without using any contrast agent. For HEs,lesion size may affect SMI performance. SMI is able to provide useful information for differential diagnosis of HCCs and metastatic lesions from HEs.

Contrast-enhanced ultrasonographic imaging diagnosis on assessment of vascularity in liver metastatic lesions

AIM: To investigate the vasculature of rabbit liver metastatic lesions by color Doppler imaging and power Doppler imaging (PDI) techniques.METHODS: Eight New Zealand rabbits with implanted VX2 liver tumors were used. All ultrasound examinations were performed with a HP 5500 color Doppler ultrasound scanner. Before and after the injection of contrast agent, the changes of gray scale and the periphery and intralesional blood flow of the liver metastatic lesion were carefully observed by B mode ultrasound, color Doppler flow imaging (CDFI)and PDI.RESULTS: Twelve lesions were found in the eight rabbits with implanted VX2 liver tumors, whose diameter rangedfrom 1.6 to 4.8 cm. Echoes of these lesions were not characterized and has lack of specificity. After the injectionof contrast agent, the numbers of dot or strip-like flow messages increased both at the periphery and inside of these lesions under the mode of CDFI and PDI, and were more pronounced under PDI. Morphology of intralesional vessels extended, even branched and some signals were clearly found encircling the lesion. And some vessels were found penetrating into the center of the lesion.CONCLUSION: PDI after injection of self-made echo contrast agent can show a pronounced sensitivity than that of B mode ultrasound and CDFI in diagnosis of vascularity of a metastatic lesion.

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.

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.

B-Flow技术在椎动脉疾病中的应用

目的 探讨二维血流显像技术在诊断椎动脉 (VA)疾病中的应用价值。方法 本组对 80例脑梗塞、糖尿病和冠心病等血管疾病多发人群 ,分别进行双侧椎动脉CDFI、PDI及B Flow检查 ,观察椎动脉形态、走行 ,管壁厚度 ,管腔内血流情况 ,并进行血流动力学检测。结果 根据所测内膜、内径和斑块等图像特征 ,可以反映椎动脉硬化及狭窄等情况。B Flow显像是一种新型血管疾病影像学检查方法 ,能同时显示血流和背景组织结构 ,与CDFI、PDI结合使用 ,能清晰显示异常影像 ,提高椎动脉疾病诊断率。结论 在椎动脉疾病的检查中 ,B

彩超及频谱Doppler超声在乳腺肿块鉴别诊断中的应用

本文对６１例６８个乳腺肿块进行了彩色Ｄｏｐｐｌｅｒ血流显像（ＣＤＦＩ）及脉冲Ｄｏｐｐｌｅｒ（ＰＤ）的检测，其中乳癌２２例，良性肿块３９例，均经手术和病理证实。结果表明：ＣＤＦＩ能迅速显示乳腺肿块的血流形态和分布，ＰＤ可区分动、静脉血流，在ＣＤＦＩ引导下进行检测可避免单纯ＰＤ检测的盲目性。动脉血流在２１例乳癌和６例乳腺良性肿块中获得，而乳癌的血流阻力指数（ＲＩ）均大于０．５５．彩超及频谱（双功彩色）Ｄｏｐｐｌｅｒ超声诊断乳腺肿块的总符合率可达９７．１％，高于灰阶超声诊断。因此，Ｄｏｐｐｌｅｒ超声对乳腺肿块性质的判断是有价值的。