Objective:?The study’s objective was to assess the accuracy of using prenatal 3-dimensional power Doppler analysis of vascular placental indices to accurately diagnose morbidly adherent placenta objectively. Backgrou...Objective:?The study’s objective was to assess the accuracy of using prenatal 3-dimensional power Doppler analysis of vascular placental indices to accurately diagnose morbidly adherent placenta objectively. Background:?Traditionally, 2D ultrasound was used for the diagnosis of a suspected morbidly adherent placenta (MAP) previa. More objective techniques like 3D power Doppler haven’t been well studied. Study Design:?A prospective cohort study?is?designed for women with gestational age between 28 and?32 weeks with suspected placenta previa. Patients were examined by 2D ultrasound which was used in management decisions.?3D Power Doppler’s VI, FI and VFI were measured during the same examination after manual tracing of placenta;data were blinded to obstetricians. Histopathology was performed to confirm MAP. Results: Our results showed that the 3D power Doppler VI ≥ 16 predicted the diagnosis of MAP with 100% sensitivity, 100% specificity which is better than those of 2D ultrasound. While VI > 33.1 measured by 3D Doppler predicted severe MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound. Conclusion:?In patients with placenta previa, the 3D Doppler’s vascular index accurately predicts MAP. Furthermore, vascular and vascular flow indices of 3D Doppler were more predictive of severe cases of MAP compared to 2D ultrasound.展开更多
Endoscopic ultrasound (EUS) has recently evolved through technological improvement of equipment,with a major clinical impact in digestive and mediastinal diseases.State-of-the-art EUS equipment now includes real-time ...Endoscopic ultrasound (EUS) has recently evolved through technological improvement of equipment,with a major clinical impact in digestive and mediastinal diseases.State-of-the-art EUS equipment now includes real-time sono-elastography,which might be useful for a better characterization of lesions and increased accuracy of differential diagnosis (for e.g.lymph nodes or focal pancreatic lesions).Contrast-enhanced EUS imaging is also available,and is already being used for the differential diagnosis of focal pancreatic masses.The recent development of low mechanical index contrast harmonic EUS imaging offers hope for improved diagnosis,staging and monitoring of anti-angiogenic treatment.Tridimensional EUS (3D-EUS) techniques can be applied to enhance the spatial understanding of EUS anatomy,especially for improved staging of tumors,obtained through a better assessment of the relationship with major surrounding vessels.Despite the progress gained through all these imaging techniques,they cannot replace cytological or histological diagnosis.However,real-time optical histological diagnosis can be achieved through the use of single-fiber confocal laser endomicroscopy techniques placed under real-time EUS-guidance through a 22G needle.Last,but not least,EUS-assisted natural orifice transluminal endoscopic surgery (NOTES) procedures offer a whole new area of imaging applications,used either for combination of NOTES peritoneoscopy and intraperitoneal EUS,but also for access of retroperitoneal organs through posterior EUS guidance.展开更多
Objective: Studying sub endometrial vascularity and blood flow in cases using intrauterine contraceptive devices for contraception with and without menorrhagia compared to cases not using intrauterine contraceptive de...Objective: Studying sub endometrial vascularity and blood flow in cases using intrauterine contraceptive devices for contraception with and without menorrhagia compared to cases not using intrauterine contraceptive devices. Methods: Three hundred and fifteen women attending gynecology and family planning outpatient clinics in the maternity hospital, Ain Shams University were included in the study. They were classified into three groups, 105 women using IUCD with menorrhagia (group I), 105 women using IUCD without menorrhagia (group II), and 105 normal controls not using IUCD (group III). After excluding local causes for bleeding, blood disease or any medical disorders, transvaginal ultrasound including three dimensional power Doppler (3DPD) ultrasound was done for all women. Right and left uterine artery pulsatility index (PI) and resistance index (RI) were calculated, subednometrial blood flow RI and PI were obtained then 3DPD Vascular indices (VI, FI and VFI) of subendometrial blood flow were obtained for all cases. Statistical analysis was done to compare between the three groups. Results: A significant statistical difference was found as regards subendometrial vascularity indices, while there was no difference as regards bilateral uterine arteries Doppler indices in the three groups. Conclusion: Subendometrial vascularity in cases of menorrhagia with IUCD was markedly higher than in cases without menorrhagia and cases with no IUCD. 3DPD may be used for selection of cases prior to insertion of IUCD.展开更多
文摘Objective:?The study’s objective was to assess the accuracy of using prenatal 3-dimensional power Doppler analysis of vascular placental indices to accurately diagnose morbidly adherent placenta objectively. Background:?Traditionally, 2D ultrasound was used for the diagnosis of a suspected morbidly adherent placenta (MAP) previa. More objective techniques like 3D power Doppler haven’t been well studied. Study Design:?A prospective cohort study?is?designed for women with gestational age between 28 and?32 weeks with suspected placenta previa. Patients were examined by 2D ultrasound which was used in management decisions.?3D Power Doppler’s VI, FI and VFI were measured during the same examination after manual tracing of placenta;data were blinded to obstetricians. Histopathology was performed to confirm MAP. Results: Our results showed that the 3D power Doppler VI ≥ 16 predicted the diagnosis of MAP with 100% sensitivity, 100% specificity which is better than those of 2D ultrasound. While VI > 33.1 measured by 3D Doppler predicted severe MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound. Conclusion:?In patients with placenta previa, the 3D Doppler’s vascular index accurately predicts MAP. Furthermore, vascular and vascular flow indices of 3D Doppler were more predictive of severe cases of MAP compared to 2D ultrasound.
基金Supported by "Utility of EUS and OCT for the minimal invasive evaluation of tumour neo-angiogenesis in the patients with digestive cancers" financed by the Romanian Ministry of Educationand Research-National University Research Council UEFISCSU-Ideas Program, No.239/2007
文摘Endoscopic ultrasound (EUS) has recently evolved through technological improvement of equipment,with a major clinical impact in digestive and mediastinal diseases.State-of-the-art EUS equipment now includes real-time sono-elastography,which might be useful for a better characterization of lesions and increased accuracy of differential diagnosis (for e.g.lymph nodes or focal pancreatic lesions).Contrast-enhanced EUS imaging is also available,and is already being used for the differential diagnosis of focal pancreatic masses.The recent development of low mechanical index contrast harmonic EUS imaging offers hope for improved diagnosis,staging and monitoring of anti-angiogenic treatment.Tridimensional EUS (3D-EUS) techniques can be applied to enhance the spatial understanding of EUS anatomy,especially for improved staging of tumors,obtained through a better assessment of the relationship with major surrounding vessels.Despite the progress gained through all these imaging techniques,they cannot replace cytological or histological diagnosis.However,real-time optical histological diagnosis can be achieved through the use of single-fiber confocal laser endomicroscopy techniques placed under real-time EUS-guidance through a 22G needle.Last,but not least,EUS-assisted natural orifice transluminal endoscopic surgery (NOTES) procedures offer a whole new area of imaging applications,used either for combination of NOTES peritoneoscopy and intraperitoneal EUS,but also for access of retroperitoneal organs through posterior EUS guidance.
文摘Objective: Studying sub endometrial vascularity and blood flow in cases using intrauterine contraceptive devices for contraception with and without menorrhagia compared to cases not using intrauterine contraceptive devices. Methods: Three hundred and fifteen women attending gynecology and family planning outpatient clinics in the maternity hospital, Ain Shams University were included in the study. They were classified into three groups, 105 women using IUCD with menorrhagia (group I), 105 women using IUCD without menorrhagia (group II), and 105 normal controls not using IUCD (group III). After excluding local causes for bleeding, blood disease or any medical disorders, transvaginal ultrasound including three dimensional power Doppler (3DPD) ultrasound was done for all women. Right and left uterine artery pulsatility index (PI) and resistance index (RI) were calculated, subednometrial blood flow RI and PI were obtained then 3DPD Vascular indices (VI, FI and VFI) of subendometrial blood flow were obtained for all cases. Statistical analysis was done to compare between the three groups. Results: A significant statistical difference was found as regards subendometrial vascularity indices, while there was no difference as regards bilateral uterine arteries Doppler indices in the three groups. Conclusion: Subendometrial vascularity in cases of menorrhagia with IUCD was markedly higher than in cases without menorrhagia and cases with no IUCD. 3DPD may be used for selection of cases prior to insertion of IUCD.
