Different hemodynamic responses by color Doppler ultrasonography studies between sildenafil non-responders and responders

Aim： To determine if there are different penile hemodynamic patterns between sildenafil non-responders and responders by using color Doppler ultrasonography. Methods： A total of 69 erectile dysfunction （ED） patients aged 22-79 years were enrolled into the present study. Thirty-eight （55.1%） men with ED who did not respond to four attempts of treatment with 100 mg sildenafil after re-education were classified as sildenafil non-responders. A com- bination of three vasodilator drugs, 1.25 mg papaverine, 0.4 mg phentolamine and 5 ug prostaglandin E1, was given by intracavernous injection before penile Doppler ultrasonography was carried out. The erectile response to intracavernous injection and vascular parameters including peak systolic velocity （PSV）, resistance index （RI）, end diastolic velocity （EDV） and cavernosa artery diameter （CD） were measured and the results between sildenafil nonresponders and responders were compared. Results： No statistical difference in vascular parameters measured by Doppler ultrasonography studies between non-responders and responders was noted. Sildenafil non-responders had a poorer penile rigidity response to intracavernous injection than responders （P 〈 0.05）. Among patients with adequate PSV （〉 30 cm/s） and abnormal EDV （〉 5 cm/s）, individuals in the non-responder group had fewer positive responses to intracavernous vasodilator injection than in the responder group （35.3% vs. 72.2%, P 〈 0.05）. Advanced age and comorbidity with diabetes mellitus were significantly associated with sildenafil non-response （P 〈 0.05）. Conclusion： Sildenafil non-responders were characterized by a poorer penile rigidity response to intracavernous injection and had an associated impaired veno-occlusive mechanism. Advanced age and comorbidity with diabetes mellitus were two common factors associated with non-response.

The value of color Doppler ultrasonography in monitoring normal orthotopic liver transplantation and postoperative complications

OBJECTIVE: To assess the value of color Doppler ultrasonography in monitoring normal orthotopic liver transplantation and postoperative complications. METHODS: Forty-one patients after orthotopic liver transplantation were examined by using color Doppler flow imaging to observe the hepatic blood flow and change of ultrasonography of the hepatic parenchyma and bile duct. The measured indexes included maximum blood flow velocity, time-average blood flow velocity (TAV), resistance index (RI) and diameter of the bile duct. RESULTS: Among 41 patients, 17 (41.5%) suffered from liver transplant rejection. Of the 17 patients, 13 (76.4%) showed decrease of TAV of the portal vein, 15 (88.25%) low-amplitude single-phase serrated wave or negative biphasic wave of the hepatic vein, 9 (52.9%) increased hepatic arterial RI, and 5 (29.4%) slightly dilated bile duct. Sonography showed disappearance of the hepatic artery blood flow around the portal vein in 5 (12.2%) of the 41 patients with hepatic artery thrombosis in the postoperative period. Slight dilatation of the intrahepatic bile duct was found in 3 (7.3%) of the 41 patients in the early postoperational period and it normalized within 2 weeks. Ultrasonography of 20 patients (48.8%) revealed a visible dilatation of the intrahepatic bile duct, which was worsening gradually. The causes of bile duct dilatation included biliary stricture in 2 patients (10%), stone in 15 patients (75%) and others in 3 patients (15%). CONCLUSIONS: Color Doppler ultrasonography is valuable for monitoring normal liver transplantation and postoperative complications.

Paper Clinical Value of Color Doppler Ultrasonography in Diagnosis of Lower Extremity Arterial Disease of Diabetes Patients

Objective: To evaluate the diagnostic value of color Doppler ultrasound in the diagnosis of diabetic lower extremity vascular diseases. Methods: 48 patients with diabetic lower extremity vascular disease admitted in our hos-pital from September 2018 to September 2019 were included in the study and divided into the observation group, and another 48 patients with the same period of health examination in our hospital were included in the study and divided into the control group. Both groups used color Doppler ultrasound to detect the blood flow of lower extremity vessels. The incidence of blood flow, vascular diameter and stenosis, occlusion and arteriosclerosis of the lower extremity were observed. Results: The blood flow and vascular di-ameter of the lower extremity in the observation group were significantly lower than those in the control group (p < 0.05). The incidence of vascular stenosis, vascular occlusion, thrombus, intimal thickening and plaque in the observation group was 85.42%, 22.92%, 10.42% and 93.75% respectively, which was significantly higher than that in the control group was 10.42%, 0.00%, 0.00% and 14.58% (p < 0.05). The incidence of lower extremity vascular lesions in the observation group was significantly higher than that in the control group (p < 0.05). Conclusion: Color Doppler ultrasound is of high diagnostic value in the diagnosis of diabetic lower extremity vascular diseases, and can be used to determine the blood flow of the lower extremity and the inner diameter of popliteal artery, thigh artery, dorsalis pedis artery and so on. At the same time, it can also clearly show the specific situation of vascular occlusion, arteriosclerosis and thrombosis, which is of great signif-icance for the prevention and diagnosis of lower extremity vascular lesions, and can provide the basis for the treatment of lower extremity vascular lesions.

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.

Use of color Doppler ultrasonography in the diagnosis of anomalous connection in pancreatobiliary disease

AIM: To estimate the detectability of anomalous connection in pancreatobiliary disease (ACPBD) cases, measuring gallbladder wall blood flow (GWBF).METHODS: In the retrospective study, we enrolled 42subjects with gallbladder wall thickening. GWBF velocity was determined as an average value of the peak velocity of color signals on the gallbladder wall, three times in each case. Based on the findings on endoscopic ultrasonography (EUS) or endoscopic retrograde cholangiopancreatography (ERCP), the 42 subjects were divided into 11 cases with ACPBD and 31 cases without ACPBD. In the prospective study, the subjects were 92 cases with gallbladder wall thickening. Using the cut-off level of the flow velocity obtained in the retrospective study, the usefulness of measuring GWBF velocity in diagnosing ACPBD was evaluated.RESULTS: In the retrospective study, imaging of GWBF was obtained in 40 of the 42 subjects. The mean GWBF velocity of the ACPBD cases was 29.4±3.9 cm/s(mean±SD), which was significantly different (P＜0.0001;95% CI 5.48-13.2) from that of the without ACPBD cases(20.1±5.9 cm/s). Based on this result, we prepared a receiver operating characteristic curve, and the cut-off level appropriate for diagnosing ACPBD was estimated to be 25 cm/s. In the prospective study, GWBF was detected in 86 of the 92 subjects. Based on the EUS or ERCP findings, the 92 subjects were divided into 15 cases with ACPBD and 77 cases without ACPBD. When a cut-off level of 25 cm/s was employed, ACPBD could be diagnosed with a sensitivity of 87.0% (13/15) and a specificity of87.3% (62/71).CONCLUSION: Measurement of GWBF velocity, which is less invasive and provides objective values, is very useful for diagnosing ACPBD prior to the development of malignant tumors in cases with gallbladder wall thickening.

COLOR DOPPLER ULTRASONOGRAPHY APPEARANCES OF RENAL VEIN THROMBOSIS AND ITS DIAGNOSTIC VALUE

Objective To evaluate color Doppler ultrasonography (CDU) appearances of renal vein thrombosis (RVT) and its diagnostic value.Methods Ten patients with RVT were analyzed retrospectively. Renal structure, distributions of intrarenal flow signals, echogenicity, and flow fullness in main renal veins were observed with CDU. Resistance index (RI) was recorded from the waveforms of segmental or interlobar renal artery.Results Ten kidneys in nine patients were confirmed to have thrombus within the main renal veins, and one patient was confirmed to have thrombus within the small intrarenal veins. The appearances of the main renal vein thrombosis included full of solid echogenicity or strip echogenicity and complete or partial filling defect within the main renal veins, and absent or a few intrarenal venous flow signals in 70% of kidneys involved. The appearances of intrarenal vein thrombosis included obscure renal structure and no venous flow signal within the involved part of the kidneys. Reverse diastolic flow in the intrarenal artery had only a sensitivity of 36% (4/11); in other 7 kidneys without intrarenal arterial reverse diastolic flow, increased RI (mean, 0.84; range, 0.74-0.96) was found.Conclusion CDU is helpful for rapid clinical diagnosis and follow-up of RVT, and therefore can be the first imaging modality of choice for RVT.

Investigation of lacrimal sac space-occupying lesions using color doppler ultrasound, computed tomography, and computed tomography dacryocystography

AIM:To observe the imaging features of color Doppler ultrasound(CDU)and computed tomography(CT)or computed tomography dacryocystography(CT-DCG)in different types of lacrimal sac space-occupying lesions(SOLs).METHODS:This retrospective case series study included 21 patients with lacrimal sac SOLs who underwent lacrimal sac surgery between January 2018 and March 2022.The imaging features of CDU and CT or CT-DCG in these patients were extracted from the examination cloud system.The images were observed and analyzed.RESULTS:The detection rate of lacrimal SOLs between CDU(21/21,100%)and CT or CT-DCG(20/21,95.2%)had no statistically significant difference(P=1.0).CDU could detect the blood flow signals in all SOLs except mucocele and mucopeptide concretion.Among them,polyps had characteristic imaging changes on CDU and CT-DCG.The mucoceles and mucopeptide concretions had characteristic imaging changes on CDU,which could provide more information for differential diagnosis.CONCLUSION:The morphology and internal blood flow signals of lacrimal sac SOLs can be observed using CDU.CT or CT-DCG has advantages in observing structural damage around the lacrimal sac mass.Therefore,CDU may be used as a routine examination to exclude lacrimal sac SOLs before dacryocystorhinostomy in the absence of preoperative CT or CT-DCG.

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.

Can the change of vasomotor activity in irritable bowel syndrome patients be detected via color Doppler ultrasound?

BACKGROUND Irritable bowel syndrome(IBS)is one of the most frequently referred conditions to the gastrointestinal outpatient clinic.The pathophysiology of IBS has not been determined with certainty.Visceral hypersensitivity is indicated as one of the pathophysiologies.The sympathetic nervous system is primarily in charge of controlling the arteries,and its effect is vasospasm in the medium and large arteries,resulting in decreased blood flow.AIM To demonstrate,using Doppler evaluation of the brachial artery,that sympathetic activity impairs vasomotor performance due to autonomic neuropathy,which we believe is associated with IBS.METHODS There were 58 participants in the study.The control group consisted of 29 healthy patients,while the remaining 29 patients had been diagnosed with IBS.Patients who met the Rome IV criteria and had IBS were included in the study.People with known polyneuropathy or non-IBS chronic conditions that can progress were excluded from the trial,as were those with essential hypertension,diabetes mellitus,cardiovascular disease,or peripheral arterial disease,and patients diagnosed with anxiety or depression.Those with moderate to severe carpal tunnel syndrome or a median nerve lesion due to trauma were also excluded from the trial.A Doppler probe was used to measure the baseline diameter and flow rates of the brachial artery from 2 cm superior to the antecubital fossa.The Doppler probe remained stationary throughout the experiment,allowing for continuous measurements.Then,to activate the sympathetic fibers,an electrical stimulus for 5 s with an intensity of 10 mA and a frequency of 1 Hz was applied to the median nerve at the wrist level via the bipolar stimulus electrode.The artery diameter and flow rates were measured again immediately following the fifth stimulus.RESULTS In healthy persons with no history of chronic illness,there was a statistically significant decrease in flow rate after stimulation(P<0.001).In addition,stimulation resulted in a statistically significant reduction in the diameter of the brachial artery(P<0.001).Patients diagnosed with IBS had statistically significant vasodilation and an increase in flow rate.CONCLUSION Sympathetic stimulation causes a reduction in vascular diameter and blood flow,whereas it has the reverse effect on IBS patients.In investigating the involvement of autonomic neuropathy in the development of IBS,significant changes in brachial artery Doppler parameters were observed before and after stimulation of the median nerve with low-current sensory stimulation.This method is thought to be more user-friendly and comfortable than other methods described in the literature.

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

ＣＨＡＲＡＣＴＥＲＩＳＴＩＣＳＯＦＴＷＯ－ＤＩＭＥＮＳＩＯＮＡＬＡＮＤＣＯＬＯＲＤＯＰＰＬＥＲＵＬＴＲＡＳＯＮＯＧＲＡＰＨＹＩＮＧＲＡＶＥＳ＇ＤＩＳＥＡＳＥ￥ＬｉＪｉａｎｃｈｕ（李建初）；ＺｈａｎｇＪｉｎｘｉ（张缙熙）；ＢａｉＹａｏ（白耀）；Ｃｈｅｎ...

Color Doppler ultrasonographic examination on the relationship between the gallbladder bed and major branch of the middle hepatic vein

BACKGROUND: There is a controversy about the risk of injury to the branch of the middle hepatic vein during lapa- roscopic cholecystectomy. This study was conducted to further investigate the relationship between the gallbladder bed and the branch of the middle hepatic vein. METHODS: Color Doppler ultrasound was used to exa- mine the anatomical relationship between the gallbladder bed and the branches of the middle hepatic vein in 143 healthy volunteers. RESULTS: Not all the middle hepatic vein extended close to the gallbladder bed, the branches and gallbladder beds in 23 subjects were not in the same plane during ultrasound scanning. In 21 of the 143 subjects the branch of the middle hepatic vein was completely adherent to the gallbladder bed with a diameter ranging from 1.2 mm to 3.6 mm. In 10 subjects the branches of the middle hepatic vein traversed approximately 1.0 mm from the gallbladder bed with a dia- meter ranging from 1.6 mm to 3.0 mm. CONCLUSIONS: In most subjects the branch of the middle hepatic vein and the gallbladder bed are well separated. Only patients with large branches of the middle hepatic vein close to the gallbladder bed are at risk of hemorrhage during laparoscopic cholecystectomy.

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.

Correlation Study of Color Doppler Examination of Deep Veins of Both Lower Extremities Combined with Fibrinolysis System in Hypertension during Pregnancy

Objective: To investigate the correlation between deep static color Doppler ultrasound of both lower extremities combined with fibrinolytic system detection in pregnancy-induced hypertension. Methods: A total of 70 normal pregnant women, 70 pregnant women with hypertension during pregnancy, and 50 healthy non-pregnant women in the same period were selected as the research objects. The deep veins of both lower limbs were examined by Rili Erlangshen’s color Doppler ultrasound diagnostic instrument (CDU), and the fibrinolysis system was tested by enzyme-linked immunosorbent assay (ELISA) method and automatic hemagglutination analyzer. Results: Compared with the non-pregnant group, the inner diameters of the left/right femoral vein (CFV) and popliteal vein (POV) in the normal pregnancy group and the pregnancy-induced hypertension group were significantly widened, and the peak blood flow spectrum was significantly reduced. The difference was statistically significant (P < 0.01);FIB, PLG, t-PA, PAI, D-Dimer were significantly increased, the difference was statistically significant (P < 0.01);Compared with the normal pregnancy group, the inner diameter of the left/right femoral vein (CFV) in the hypertensive pregnancy group was significantly wider than that in the normal pregnancy group, and the peak value of the left/right POV blood flow spectrum was significantly lower than that in the normal pregnancy group, the difference was statistically significant (P < 0.01), while the left/right popliteal vein (POV) inner diameter, left/right CFV blood flow peak value did not change significantly from the normal pregnancy group, and the difference was not statistically significant (P > 0.05);FIB, PLG, PAI, D-Dimer of the hypertensive disease group during pregnancy significantly increased, the difference was statistically significant (P < 0.01), while t-PA was not statistically significant (P > 0.05). Conclusion: Normal pregnant women have a hypercoagulable state compared with healthy non-pregnant women, and pregnant women with hypertension during pregnancy are more likely to be in a pre-thrombotic state than pregnant women with normal pregnancy. Deep vein CDU examination of both lower extremities combined with blood fibrinolysis monitoring is of great value in the prevention and treatment of hypertension during pregnancy.

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.

The Diagnostic Value of Color Doppler Ultrasound and Grey Scale Sonography in Predicting the Malignancy of Thyroid Nodules

Retrospective study was done at KAUH to determine the sonographic characteristics in predicting the malignancy of thyroid nodules. The sample was 120 patients consisting of 70 benign nodules and 50 malignant nodules. Out of 120 patients, 106 (88.3%) female and 14 (11.7%) male patients. Out of 106 female patients, 64 (91.45) had benign and 42 had malignant thyroid nodules. Out of 14 (11.7) male patients, 6 had benign and 8 had malignant thyroid nodules. The youngest patient in our study was 31 years and the oldest patient was 76 years. The common range of patients age was ≥ 60 years and consisting of twenty (28.6%) benign thyroid nodules and fourteen (28%) malignant thyroid nodules. The majority of patients’ age group with malignant thyroid nodules were between 50 - 60 years and consisting of twenty (40%) malignant nodules. In our study, according to the result of gray scale and color Doppler ultrasonography, hypo-echogenicity, solid echo structure, micro-calcification and intra-nodular vascularity were the significant characteristics of malignancy in nodules with sensitivity (72%, 74%, 48% and 88% respectively), specificity (66%, 63%, 94% and 69% respectively), PPV (60%, 59%, 86% and 67% respectively) and NPV (77%, 77%, 72% and 89% respectively).

Assessment of Uterine Receptivity by Endometrial and Subendometrial Blood Flows Measured by Vaginal Color Doppler Ultrasound in Women Undergoing IVF Treatment

Objective To evaluate endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound as a predicator of endometrial receptivity in women undergoing IVF treatment. Methods A total of 119 infertile patients undergoing the first IVF/ICSI-ET cycle were recruited. Three groups were divided according to a color Doppler ultrasound examination performed on the day of hCG injection. Group A, endometrial and subendometrial blood flows were 2 branches and below; group B, endometrial and subendometrial blood flows were between 3 and 4 branches; group C, endometrial and subendometrial blood flows were 5 branches and above. Patients were transferred 1-3 embryos each. Demographic data, ovarian responses, endometrial thickness, PI, RI, development of embryo and IVF result among groups were compared. Results Demographic data, ovarian responses, endometrial thickness, PI, RI and development of embryo among groups have no significant difference. The pregnancy rate of group A was significantly lower than that of group B （P〈0.05） and group C （P〈0.01）. The implantation rate of group A was significantly lower than than of group C （P〈0.01）. There was no significant difference of the rate of pregnancy and implantation between group B and group C （P〉0.05）. Conclusion Endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound is a good predicator of pregnancy during IVF treatment. A good endometrial and subendometrial blood flows is benefit for the result of IVF.

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...

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.

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.

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.