Objective:?The aim of this study is to assess any potential relationship between perifollicular vascularity and occurrence of pregnancy in cases of stimulated IUI cycles using the subjective grading system by 2D trans...Objective:?The aim of this study is to assess any potential relationship between perifollicular vascularity and occurrence of pregnancy in cases of stimulated IUI cycles using the subjective grading system by 2D transvaginal power Doppler ultrasonography.?Design: A prospective cross sectional cohort study. Method: This is a prospective cross-sectional cohort study of 90 stimulated IUI treatment cycles. Selected women were prescribed clomiphene citrate combined with highly purified urinary follicle stimulating hormone. All patients underwent serial transvaginal ultrasound scans starting from day 6 to 7 of the cycle. Perifollicular Doppler blood flows were assessed in dominant follicles ≥18 mm. The patients then were categorized into 3 groups (high vascularity group {G3 & G4}, low vascularity group {G1 & G2} and mixed grades group). Other parameters measured included number of follicles ≥ 18 mm in both ovaries, endometrial thickness and estradiol (E2) level . Human chorionic gonadotropin (hCG) injection 10,000 IU IM was given to the patient when the dominant follicle reached 18 mm in diameter. At that time, the endometrium was evaluated as regards endometrial thickness. IUI was carried out using prepared/“washed” semen (husband). All patients received luteal support in the form of progesterone from day of IUI for 14 days. Serum Β-hCG was estimated 2 weeks after insemination. Results: In this study, from all 90 cases only 8 cases got pregnant with pregnancy rate of 8.88% (6 cases got pregnant in high grade vascularity group;2 cases in mixed grades group and no cases got pregnant?in low grade group). There was statistically significant difference among the 3 groups as regarding?the pregnancy rate (P value = 0.02). There is statistically significant difference in perifollicular resistance index (RI) and pulsatility index (PI) between pregnant and non pregnant cases (P value = 0.016 and 0.047 respectively). In this study, there is no statistically significant difference between pregnant and non pregnant cases as regarding endometrial thickness and E2 level at the day of hCG administration (P value = 0.39 and 0.76 respectively). Conclusion: Perifollicular blood-flow assessment by 2D transvaginal power Doppler is a good predictive for the outcome of stimulated IUI cycles.展开更多
Rheumatoid arthritis is a chronic multisystem disease of unknown cause. The characteristic feature of RA is persistent inflammatory synovitis. The natural history of disease is such that the early months of the diseas...Rheumatoid arthritis is a chronic multisystem disease of unknown cause. The characteristic feature of RA is persistent inflammatory synovitis. The natural history of disease is such that the early months of the disease are critical period during which reversible joint damage occurs. So early diagnosis of RA and appropriate drug application is the only way to save a patient from this crippling disease. In India, the cost of investigations is a significant factor for most of the patients. Ultrasonography or Power Doppler Ultra Sound (PDUS) has the advantage of being economic in spite of its sensitivity in assessing both inflammatory and destructive changes. The aim of the present study was to evaluate the diagnostic efficiency of PDUS in early rheumatoid arthritis. The study was performed with the patients attending Rheumatology Clinic. A total number of 106 patients of clinically suspected rheumatoid arthritis were studied as per selection criteria. Radiological examinations of hands were done by digital radiography and PDUS in a group of 53 patients, assessment of foot changes by PDUS and Digital Radiography were done in another similar group of 53 patients. Final diagnosis by ACR EULAR-2010 criteria is done for all the patients. The comparative study reveals that synovial vascularity as demonstrated by PDUS is much more effective in diagnosing early rheumatoid arthritis, both in hand and in feet than digital radiograph. PDUS of feet may yield earlier and better findings than hands, which is conventionally used in patients suffering from early rheumatoid arthritis.展开更多
Objective:To study the changes in three-dimensional power Doppler ultrasound features before and after neoadjuvant chemotherapy for cervical cancer and their relationship with malignant molecule expression.Methods: Th...Objective:To study the changes in three-dimensional power Doppler ultrasound features before and after neoadjuvant chemotherapy for cervical cancer and their relationship with malignant molecule expression.Methods: The patients who were diagnosed with cervical cancer and received neoadjuvant chemotherapy in Wuhan Red Cross Hospital between March 2015 and October 2017 were selected as the cervical cancer group, and the patients who received cervical biopsy and were diagnosed with stage I cervical intraepithelial neoplasia by pathological findings during the same period were selected as the control group. Before biopsy, three-dimensional power Doppler ultrasonography was performed to measure VI, FI and VFI;the tissues of cervical cancer group before and after chemotherapy as well as the biopsy tissues of control group were collected to measure the expression of proliferation genes, invasion genes and angiogenesis genes.Results: The VI, FI and VFI levels as well as the Piwil2 gene (Piwil2), CyclinD1, N-Myc downstream regulated gene 3 (NDRG3), CXC chemokine ligand 5 (CXCL5), cathepsin-L (CAT-L), EGF-containing fibulin-like extracellular matrix protein 1 (EFEMP1), angiotensin (Ang)1, Ang2 and angiopoietin-like protein 4 (ANGPTL4) mRNA expression levels in the tissues of cervical cancer group before and after chemotherapy were all significantly higher than those of control group whereas the thrombospondin 2 (THBS2), Smac gene (Smac), large tumor suppressor kinase 1 (LATS1), reversion-inducing-cysteine-rich protein with kazal motifs (RECK) and plas minogen activator inhibitor 1 (PAI-1) mRNA expression levels in the tissues were all significantly lower than those of control group, and the VI, FI and VFI levels as well as the Piwil2, CyclinD1, NDRG3, CXCL5, CAT-L, EFEMP1, Ang1, Ang2 and ANGPTL4 mRNA expression levels in the tissues of cervical cancer group after chemotherapy were all significantly lower than those before chemotherapy whereas the THBS2, Smac, LATS1, RECK and PAI-1 mRNA expression levels were all significantly higher than those before chemotherapy;the VI, FI and VFI levels in cervical cancer tissues were positively correlated with the Piwil2, CyclinD1, NDRG3, CXCL5, CAT-L, EFEMP1, Ang1, Ang2 and ANGPTL4 mRNA expression levels, and negatively correlated with the THBS2, Smac, LATS1, RECK and PAI-1 mRNA expression levels.Conclusion: The changes in the three-dimensional power Doppler ultrasound parameters before and after neoadjuvant chemotherapy for cervical cancer can reflect the changes in proliferation, invasion and angiogenesis gene expression in the lesions.展开更多
Sometimes endometrial polyps,submucosal myomas,and endometrial cancer show similar findings under ultrasonography.The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensi...Sometimes endometrial polyps,submucosal myomas,and endometrial cancer show similar findings under ultrasonography.The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensional(3D)power Doppler ultrasonography angiography(PDA)between endometrial cancer and uterine parenchyma lumps.The data of the blood flow indices in 3D-PDA including the vascularization index(VI),flow index(FI),and vascularization flow index(VFI)in 40 patients with endometrial cancer and 41 patients with uterine parenchyma lumps(endometrial polyps and submucosal myomas)were retrospectively analysed and compared utilizing Virtual Organ Computer-aided AnaLysis(VOCAL)software.The results showed that all the blood flow parameters(VI,FI,VFI)were significantly higher in women with endometrial cancer than in those with uterine parenchyma lumps(P<0.001).The area under the curve of ROC of VI,FI,and VFI was 0.98,0.84,and 0.97,respectively.Thus,the best predictor of endometrial carcinoma was VI with a sensitivity of 97.0% and a specificity of 91.0%.The optimal cutoff value of VI was 4.06%.Our data demonstrated that all of the blood flow signal parameters(including VI,FI,and VFI)in 3D power Doppler ultrasonography had significant antidiastole values between endometrial cancer and uterine parenchyma lumps to assist clinicians in properly diagnosing patients.展开更多
Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the la...Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the last decade, ultrasound(US) has become a practical imaging tool for the assessment of articular and periarticular pathologies, including joint synovitis, tenosynovitis, and enthesitis in rheumatic diseases. Progress in power Doppler(PD) technology has enabled evaluation of the strength of ongoing inflammation. PDUS is very useful for identifying the location and kind of pathologies in rheumatic ankles as well as for distinguishing between inflammatory processes and degenerative changes or between active inflammation and residual damage. The aim of this paper is to illustrate the US assessment of ankle lesions in patients with inflammatory rheumatic diseases, including rheumatoid arthritis, spondyloarthritis, and systemic lupus erythematosus, focusing on the utility of PDUS.展开更多
Objectives: To evaluate the role of Doppler ultrasound in prediction and follow up during management of gestational trophoblastic neoplasia (GTN). Methods: The study was performed at Oncology Unit, Maternity Hospital,...Objectives: To evaluate the role of Doppler ultrasound in prediction and follow up during management of gestational trophoblastic neoplasia (GTN). Methods: The study was performed at Oncology Unit, Maternity Hospital, Ain Shams University in the period from November 2015 to December 2018. Forty cases of complete mole, after evacuation and follow up of serum human chorionic gonodotrophin (β-hCG) titre until it reached zero level (group I) and forty post molar GTN cases (group II) were included in the study. Doppler ultrasound of the subendometrial and intramural blood flow was done for all cases of group I and II. Doppler included two dimensional and three dimensional power Doppler indices. Group II received Methotrexate (MTX) and folinic acid in a dose of 8-day MTX-FA regimen. Doppler follow up for six months of group II concurrently with the chemotherapy regimen was done. Results: A statistically significant difference was found between group I and II regarding initial readings of all Doppler parameters. Follow up for 6 months of GTN cases revealed progressive statistically significant decrease of intramural and subendometrial three dimensional power Doppler (3DPD) indices, while there was a significant increase in two dimensional (2D) Doppler parameters. Four cases were resistant to Methotrexate chemotherapy. Cut off values were determined for prediction of GTN. Multivariate analysis revealed that the most predictive parameter was the subendometrial pulsatility index (PI), odds ratio = 10.63 (95% CI: 1.30 - 86.89). The cut-off point for sub-endometrial PI was: 2.05 (AUC, 90%;sensitivity, 88%;specificity, 76%, PPV 78%, and NPV 86%) with a diagnostic accuracy of 87%. To and Fro sign may be considered a pathognomonic intramural ultrasound sign for prediction of GTN chemo-resistance or choriocarcinoma. Conclusion: Cut off values for Doppler parameters can be used for early predication of GTN. Doppler ultrasound indices can be used during follow up of GTN cases concurrently with serum β-hCG to monitor the response to treatment.展开更多
Objective:To study the correlation of ultrasound vascularization index and flow index of thyroid cancer with tumor malignancy.Methods: A total of 140 patients with thyroid nodule who accepted surgical resection in our...Objective:To study the correlation of ultrasound vascularization index and flow index of thyroid cancer with tumor malignancy.Methods: A total of 140 patients with thyroid nodule who accepted surgical resection in our hospital between May 2013 and June 2016 were selected as the research subjects, the patients with malignant thyroid nodule were included in the malignant group of the research and patients with benign thyroid nodule were included in the benign group of research. Three-dimensional power Doppler ultrasonography was conducted before operation to determine vascularization index (VI), flow index (FI) and vascularization flow index (VFI);tumor tissues were collected after operation to detect the expression of angiogenesis as well as cell proliferation, apoptosis and invasion-related molecules.Results:VI, FI and VFI levels of tumor tissue of malignant group were significantly higher than those of benign group;VEGF, MK, Ang-2, IGF-Ⅱ, Bcl-2, Livin, Wip1, S100A4, TCF,β-catenin and SATB1 protein expression in tumor tissue of malignant group were significantly higher than those of benign group and positively correlated with VI, FI and VFI levels while CCNG2 and p27 protein expression were significantly lower than those of benign group and negatively correlated with VI, FI and VFI levels.Conclusion:Ultrasound vascularization index and flow index of thyroid cancer increase significantly and are closely related to the angiogenesis as well as cell proliferation, apoptosis and invasion.展开更多
文摘Objective:?The aim of this study is to assess any potential relationship between perifollicular vascularity and occurrence of pregnancy in cases of stimulated IUI cycles using the subjective grading system by 2D transvaginal power Doppler ultrasonography.?Design: A prospective cross sectional cohort study. Method: This is a prospective cross-sectional cohort study of 90 stimulated IUI treatment cycles. Selected women were prescribed clomiphene citrate combined with highly purified urinary follicle stimulating hormone. All patients underwent serial transvaginal ultrasound scans starting from day 6 to 7 of the cycle. Perifollicular Doppler blood flows were assessed in dominant follicles ≥18 mm. The patients then were categorized into 3 groups (high vascularity group {G3 & G4}, low vascularity group {G1 & G2} and mixed grades group). Other parameters measured included number of follicles ≥ 18 mm in both ovaries, endometrial thickness and estradiol (E2) level . Human chorionic gonadotropin (hCG) injection 10,000 IU IM was given to the patient when the dominant follicle reached 18 mm in diameter. At that time, the endometrium was evaluated as regards endometrial thickness. IUI was carried out using prepared/“washed” semen (husband). All patients received luteal support in the form of progesterone from day of IUI for 14 days. Serum Β-hCG was estimated 2 weeks after insemination. Results: In this study, from all 90 cases only 8 cases got pregnant with pregnancy rate of 8.88% (6 cases got pregnant in high grade vascularity group;2 cases in mixed grades group and no cases got pregnant?in low grade group). There was statistically significant difference among the 3 groups as regarding?the pregnancy rate (P value = 0.02). There is statistically significant difference in perifollicular resistance index (RI) and pulsatility index (PI) between pregnant and non pregnant cases (P value = 0.016 and 0.047 respectively). In this study, there is no statistically significant difference between pregnant and non pregnant cases as regarding endometrial thickness and E2 level at the day of hCG administration (P value = 0.39 and 0.76 respectively). Conclusion: Perifollicular blood-flow assessment by 2D transvaginal power Doppler is a good predictive for the outcome of stimulated IUI cycles.
文摘Rheumatoid arthritis is a chronic multisystem disease of unknown cause. The characteristic feature of RA is persistent inflammatory synovitis. The natural history of disease is such that the early months of the disease are critical period during which reversible joint damage occurs. So early diagnosis of RA and appropriate drug application is the only way to save a patient from this crippling disease. In India, the cost of investigations is a significant factor for most of the patients. Ultrasonography or Power Doppler Ultra Sound (PDUS) has the advantage of being economic in spite of its sensitivity in assessing both inflammatory and destructive changes. The aim of the present study was to evaluate the diagnostic efficiency of PDUS in early rheumatoid arthritis. The study was performed with the patients attending Rheumatology Clinic. A total number of 106 patients of clinically suspected rheumatoid arthritis were studied as per selection criteria. Radiological examinations of hands were done by digital radiography and PDUS in a group of 53 patients, assessment of foot changes by PDUS and Digital Radiography were done in another similar group of 53 patients. Final diagnosis by ACR EULAR-2010 criteria is done for all the patients. The comparative study reveals that synovial vascularity as demonstrated by PDUS is much more effective in diagnosing early rheumatoid arthritis, both in hand and in feet than digital radiograph. PDUS of feet may yield earlier and better findings than hands, which is conventionally used in patients suffering from early rheumatoid arthritis.
文摘Objective:To study the changes in three-dimensional power Doppler ultrasound features before and after neoadjuvant chemotherapy for cervical cancer and their relationship with malignant molecule expression.Methods: The patients who were diagnosed with cervical cancer and received neoadjuvant chemotherapy in Wuhan Red Cross Hospital between March 2015 and October 2017 were selected as the cervical cancer group, and the patients who received cervical biopsy and were diagnosed with stage I cervical intraepithelial neoplasia by pathological findings during the same period were selected as the control group. Before biopsy, three-dimensional power Doppler ultrasonography was performed to measure VI, FI and VFI;the tissues of cervical cancer group before and after chemotherapy as well as the biopsy tissues of control group were collected to measure the expression of proliferation genes, invasion genes and angiogenesis genes.Results: The VI, FI and VFI levels as well as the Piwil2 gene (Piwil2), CyclinD1, N-Myc downstream regulated gene 3 (NDRG3), CXC chemokine ligand 5 (CXCL5), cathepsin-L (CAT-L), EGF-containing fibulin-like extracellular matrix protein 1 (EFEMP1), angiotensin (Ang)1, Ang2 and angiopoietin-like protein 4 (ANGPTL4) mRNA expression levels in the tissues of cervical cancer group before and after chemotherapy were all significantly higher than those of control group whereas the thrombospondin 2 (THBS2), Smac gene (Smac), large tumor suppressor kinase 1 (LATS1), reversion-inducing-cysteine-rich protein with kazal motifs (RECK) and plas minogen activator inhibitor 1 (PAI-1) mRNA expression levels in the tissues were all significantly lower than those of control group, and the VI, FI and VFI levels as well as the Piwil2, CyclinD1, NDRG3, CXCL5, CAT-L, EFEMP1, Ang1, Ang2 and ANGPTL4 mRNA expression levels in the tissues of cervical cancer group after chemotherapy were all significantly lower than those before chemotherapy whereas the THBS2, Smac, LATS1, RECK and PAI-1 mRNA expression levels were all significantly higher than those before chemotherapy;the VI, FI and VFI levels in cervical cancer tissues were positively correlated with the Piwil2, CyclinD1, NDRG3, CXCL5, CAT-L, EFEMP1, Ang1, Ang2 and ANGPTL4 mRNA expression levels, and negatively correlated with the THBS2, Smac, LATS1, RECK and PAI-1 mRNA expression levels.Conclusion: The changes in the three-dimensional power Doppler ultrasound parameters before and after neoadjuvant chemotherapy for cervical cancer can reflect the changes in proliferation, invasion and angiogenesis gene expression in the lesions.
基金This research was supported by grants from the National Natural Science Foundation of China(No.81501530)Hubei Province Health and Family Planning Scientific Research Project(No.WJ2019M130).
文摘Sometimes endometrial polyps,submucosal myomas,and endometrial cancer show similar findings under ultrasonography.The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensional(3D)power Doppler ultrasonography angiography(PDA)between endometrial cancer and uterine parenchyma lumps.The data of the blood flow indices in 3D-PDA including the vascularization index(VI),flow index(FI),and vascularization flow index(VFI)in 40 patients with endometrial cancer and 41 patients with uterine parenchyma lumps(endometrial polyps and submucosal myomas)were retrospectively analysed and compared utilizing Virtual Organ Computer-aided AnaLysis(VOCAL)software.The results showed that all the blood flow parameters(VI,FI,VFI)were significantly higher in women with endometrial cancer than in those with uterine parenchyma lumps(P<0.001).The area under the curve of ROC of VI,FI,and VFI was 0.98,0.84,and 0.97,respectively.Thus,the best predictor of endometrial carcinoma was VI with a sensitivity of 97.0% and a specificity of 91.0%.The optimal cutoff value of VI was 4.06%.Our data demonstrated that all of the blood flow signal parameters(including VI,FI,and VFI)in 3D power Doppler ultrasonography had significant antidiastole values between endometrial cancer and uterine parenchyma lumps to assist clinicians in properly diagnosing patients.
文摘Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the last decade, ultrasound(US) has become a practical imaging tool for the assessment of articular and periarticular pathologies, including joint synovitis, tenosynovitis, and enthesitis in rheumatic diseases. Progress in power Doppler(PD) technology has enabled evaluation of the strength of ongoing inflammation. PDUS is very useful for identifying the location and kind of pathologies in rheumatic ankles as well as for distinguishing between inflammatory processes and degenerative changes or between active inflammation and residual damage. The aim of this paper is to illustrate the US assessment of ankle lesions in patients with inflammatory rheumatic diseases, including rheumatoid arthritis, spondyloarthritis, and systemic lupus erythematosus, focusing on the utility of PDUS.
文摘Objectives: To evaluate the role of Doppler ultrasound in prediction and follow up during management of gestational trophoblastic neoplasia (GTN). Methods: The study was performed at Oncology Unit, Maternity Hospital, Ain Shams University in the period from November 2015 to December 2018. Forty cases of complete mole, after evacuation and follow up of serum human chorionic gonodotrophin (β-hCG) titre until it reached zero level (group I) and forty post molar GTN cases (group II) were included in the study. Doppler ultrasound of the subendometrial and intramural blood flow was done for all cases of group I and II. Doppler included two dimensional and three dimensional power Doppler indices. Group II received Methotrexate (MTX) and folinic acid in a dose of 8-day MTX-FA regimen. Doppler follow up for six months of group II concurrently with the chemotherapy regimen was done. Results: A statistically significant difference was found between group I and II regarding initial readings of all Doppler parameters. Follow up for 6 months of GTN cases revealed progressive statistically significant decrease of intramural and subendometrial three dimensional power Doppler (3DPD) indices, while there was a significant increase in two dimensional (2D) Doppler parameters. Four cases were resistant to Methotrexate chemotherapy. Cut off values were determined for prediction of GTN. Multivariate analysis revealed that the most predictive parameter was the subendometrial pulsatility index (PI), odds ratio = 10.63 (95% CI: 1.30 - 86.89). The cut-off point for sub-endometrial PI was: 2.05 (AUC, 90%;sensitivity, 88%;specificity, 76%, PPV 78%, and NPV 86%) with a diagnostic accuracy of 87%. To and Fro sign may be considered a pathognomonic intramural ultrasound sign for prediction of GTN chemo-resistance or choriocarcinoma. Conclusion: Cut off values for Doppler parameters can be used for early predication of GTN. Doppler ultrasound indices can be used during follow up of GTN cases concurrently with serum β-hCG to monitor the response to treatment.
文摘Objective:To study the correlation of ultrasound vascularization index and flow index of thyroid cancer with tumor malignancy.Methods: A total of 140 patients with thyroid nodule who accepted surgical resection in our hospital between May 2013 and June 2016 were selected as the research subjects, the patients with malignant thyroid nodule were included in the malignant group of the research and patients with benign thyroid nodule were included in the benign group of research. Three-dimensional power Doppler ultrasonography was conducted before operation to determine vascularization index (VI), flow index (FI) and vascularization flow index (VFI);tumor tissues were collected after operation to detect the expression of angiogenesis as well as cell proliferation, apoptosis and invasion-related molecules.Results:VI, FI and VFI levels of tumor tissue of malignant group were significantly higher than those of benign group;VEGF, MK, Ang-2, IGF-Ⅱ, Bcl-2, Livin, Wip1, S100A4, TCF,β-catenin and SATB1 protein expression in tumor tissue of malignant group were significantly higher than those of benign group and positively correlated with VI, FI and VFI levels while CCNG2 and p27 protein expression were significantly lower than those of benign group and negatively correlated with VI, FI and VFI levels.Conclusion:Ultrasound vascularization index and flow index of thyroid cancer increase significantly and are closely related to the angiogenesis as well as cell proliferation, apoptosis and invasion.
