scholarly journals A longitudinal study on parotid and submandibular gland changes assessed by magnetic resonance imaging and ultrasonography in post-radiotherapy nasopharyngeal cancer patients

BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20200003
Author(s):  
Vincent W.C. Wu ◽  
Michael TC Ying ◽  
Dora LW Kwong ◽  
Pek-Lan Khong ◽  
Gary KW Wong ◽  
...  

Objectives: With regard to the intensity modulated radiotherapy (IMRT) of nasopharyngeal carcinoma (NPC) patients, this longitudinal study evaluated the radiation-induced changes in the parotid and submandibular glands in terms of gland size, echogenicity and haemodynamic parameters. Methods: 21 NPC patients treated by IMRT underwent MRI and ultrasound scans before radiotherapy, and at 6, 12, 18 and 24 months after treatment. Parotid and submandibular gland volumes were measured from the MRI images, whereas the parotid echogenicity and haemodynamic parameters including the resistive index, pulsatility index, peak systolic velocity and end diastolic velocity were evaluated by ultrasonography. Trend lines were plotted to show the pattern of changes. The correlations of gland doses and the post-RT changes were also studied. Results: The volume of the parotid and submandibular glands demonstrated a significant drop from pre-RT to 6 months post-RT. The parotid gland changed from hyperechoic before RT to either isoechoic or hypoechoic after treatment. The resistive index and pulsatility index decreased from pre-RT to 6 month post-RT, then started to increase at 12 month time interval. Both peak systolic velocity and end diastolic velocity increased after 6 months post-RT then followed a decreasing trend up to 24 months post-RT. There was mild correlation between post-RT gland dose and gland volume, but not with haemodynamic changes. Conclusions: Radiation from IMRT caused shrinkage of parotid and submandibular glands in NPC patients. It also changed the echogenicity and vascular condition of the parotid gland. The most significant changes were observed at 6 months after radiotherapy. Advances in knowledge: It is the first paper that reports on the longitudinal changes of salivary gland volume, echogenicity and haemodynamic parameters altogether in NPC patients after radiotherapy. The results are useful for the prediction of glandular changes that is associated with xerostomia, which help to provide timely management of the complication when the patients attend follow-up visits.

2018 ◽  
Vol 46 (1) ◽  
pp. 5
Author(s):  
Ivan Felismino Charas Dos Santos ◽  
Letícia Rocha Inamassu ◽  
Sheila Canevese Rahal ◽  
Maria Jaqueline Mamprim ◽  
David José De Castro Martins ◽  
...  

Background: In Veterinary Medicine, there are several methods for early and accurate assessment of blood flow dynamics. The Dopplerfluxometry can access the peak systolic velocity, mean velocity and end diastolic velocity, including Resistive Index and Pulsatility Index. Normal values of Dopplerfluxometry in healthy dogs allow the identification of vascular abnormalities and authors’ knowledge there are no reference regarding the values of Dopplerfluxometry of the femoral artery in healthy dogs. The aim of the study was to assess the femoral Dopplerfluxometry of adult healthy dogs by Resistive Index, Pulsatility Index, systolic and diastolic velocities, and femoral artery diameter.Materials, Methods & Results: Eighteen healthy intact beagle dogs, male and female, aging from 2 to 4 years old (mean ± SD: mean 3 ± 0.8 years), weighing from 10.1-17.9 kg [22.3-39.5 lb] [mean ± SD: 14.3 ± 2.7 kg (31.5 ± 5.96 lb)] were used. The dogs underwent to physical examination, complete blood cell count, serum biochemistry examination urinalysis, and radiographs examination, muscular and cardiac evaluation. Females had to be in anestrous. All dogs were submitted to right femoral artery Dopplerfluxometry. The dogs were positioned in dorsal recumbency by one person without any chemical restraint. A high definition ultrasound device equipped with a 3 - 13 MHz multi-frequency linear transducer was used. The right femoral artery was identified with the transducer positioned transversely on the right triangle femoral area. Peak systolic velocity, end-diastolic velocity was measured. The Resistivity Index and Pulsatility Index were calculated automatically by the ultrasound machine software. Three measurements were obtained with the Doppler spectrum. The values of peak systolic velocity, end-diastolic velocity, Resistivity Index, Pulsatility Index and femoral artery diameter were expressed as Mean ± Standard Deviation (SD).Discussion: No studies regarding to femoral artery Dopplerfluxometry in healthy dogs were found in the literature. These results can be used as normal reference values of Dopplerfluxometric parameters for adult dogs. The literature cited only Dopplerfluxometric values of renal arteries, abdominal aorta and of the internal thoracic artery. The normal values of arterial Dopplerfluxometry is necessary to identify the spectral quantitative characteristics of the blood flow for diagnosis and prognosis of vascular diseases. Authors referred to changes in blood perfusion by Dopplerfluxometry examination, but no changes in B-mode ultrasonography. The femoral Resistivity Index values can be used to correlate the postoperative evolution in dogs submitted to femoral bone, hip and knee surgeries, since Dopplerfluxometry allows blood flow assessment in the femoral region muscles. Changes in the heart rate, blood pressure, stress, exercise, and diseases as hypotension, renal lesion, hepatic diseases, diabetes, hyperadrenocorticism can change the Dopplerfluxometric parameters. All dogs which used in this study were clinically healthy, and were used beagle dogs due to lowest variations within breed. Sedation was avoid due to possible changes in Dopplerfluxometric parameters since the use of sedation or tranquilization in animals is strongly discussed due to possible hemodynamic changes that may occur during the examination. In conclusion, the mean values of the right femoral artery Dopplerfluxometry in male and female adult healthy dogs is Resistivity Index (0.887); Pulsatility Index (1.599); peak systolic velocity (124.41 cm/s), end-diastolic velocity (14.12 cm/s), femoral artery diameter (3.9 mm).


BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
A Parello ◽  
F Litta ◽  
V De Simone ◽  
P Campennì ◽  
R Orefice ◽  
...  

Abstract Background Arterial hyperflow to haemorrhoids has been implicated as a possible pathophysiological co-factor in haemorrhoidal disease. The purpose of this study was to investigate how transanal haemorrhoidal dearterialization (THD) can influence haemodynamic parameters at the level of the haemorrhoidal piles. Methods Patients with grade III haemorrhoids selected for THD between July and December 2018 were evaluated using endoanal ultrasonography and colour Doppler imaging at the level of internal haemorrhoids before and 1 year after the surgical procedure. Peak systolic velocity, pulsatility index, resistivity index, acceleration time, and end-diastolic velocity were measured, and preoperative and postoperative values compared. Symptom severity was measured using a symptom-based questionnaire (score range 0–20). Results Of 21 patients treated, 17 completed the study. Compared with preoperative values, postoperative peak systolic velocity (mean(s.d.) 18.7(1.1) versus 10.3(0.4) cm/s; P < 0.05), pulsatility index (5.5(0.3) versus 2.8(0.4); P < 0.050), and resistivity index (1.0(0.2) versus 0.8(0.5); P < 0.050) decreased significantly, whereas acceleration time increased significantly (65.6(3.6) versus 83.3(4.7) cm/s2; P < 0.050); end-diastolic velocity did not change (1.9(0.2) versus 2.0(0.4); P = 0.753). Symptoms disappeared or had improved significantly in all patients by 1 year after surgery. The mean(s.d.) total symptom severity score decreased from 15.8(1.1) to 1.2(1.6) (P < 0.001). Conclusion THD affects the main haemodynamic parameters at the level of internal haemorrhoids and is associated with a decrease in arterial hyperflow.


2020 ◽  
Vol 48 (5) ◽  
pp. 504-508
Author(s):  
Ya Tan ◽  
Shi Zeng ◽  
YuShan Liu ◽  
HuaYu Tang ◽  
BaiHua Zhao

AbstractObjectiveTo observe Doppler ultrasound changes in the two segments of the posterior cerebral artery (PCA) in fetuses with transposition of the great arteries (TGA).MethodsThe peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI), and velocity-time integral (VTI) of the two segments of PCA (the first segment: PCAS1, the second segment: PCAS2) and of the middle cerebral artery (MCA) were compared in TGA fetuses and normal fetuses. The abnormality rate between the PCAS1-PI and MCA-PI was compared in TGA fetuses.ResultsThe PCAS1-PI and MCA-PI were smaller in the TGA fetuses than in the controls (all P < 0.05), but the PCAS2-PI was unchanged (P > 0.05). The MCA-VTI, PCAS1-VTI, and PCAS2-VTI were larger in the TGA fetuses (all P < 0.05). In the TGA fetuses, the abnormality rate of the PCAS1-PI was significantly higher than that of the MCA-PI (P < 0.05).ConclusionIn fetuses with TGA, there were hemodynamic differences between the two segments of the posterior cerebral arteries. Moreover, PCAS1 exhibited signs of vasodilatation more obviously than did the MCA in fetuses with TGA.


Author(s):  
Andrej Udelnow ◽  
Maria Hawemann ◽  
Ivo Buschmann ◽  
Frank Meyer ◽  
Zuhir Halloul

Summary Background Hypothesis: Post-exercise measurements better discriminate PAOD-patients from healthy persons and they more sensitively detect hemodynamic improvements after treatment procedures than resting measurements. Methods A total of 19 healthy volunteers and 23 consecutive PAOD-patients underwent measurements of peak systolic velocity (PSV), end-diastolic velocity (EDV), minimal diastolic velocity (MDV), time-averaged maximum velocities (TAMAX), resistance index (RI) and pulsatility index (PI) before and after a standard exercise test (at 1, 2, 3, 4 and 5 min) before and after treatment (incl. epidemiological data, PAOD risk factors and comorbidities). Results In resting values, healthy persons and PAOD-patients did not differ significantly in any of the hemodynamic parameters. PSV increased after treatment in PAOD-patients by 5 cm/s (paired t‑test, p: 0.025); however, when the amplitude of autoregulatory changes related to the resting values were calculated, PAOD-patients showed clearly less hemodynamic changes after exercise than healthy persons (p: 0.04; 0.002; <0.001 for PSV, TAMAX and PI, resp.). The time course after exercise was compared by repeated measures of ANOVA. Healthy persons differed significantly in PI, RI and PSV from PAOD patients before and after treatment (p<0.001 each). The PAOD-patients revealed a significantly improved PI after treatment (p: 0.042). The only factor contributing significantly to PI independently from grouping was direct arterial vascularization as compared to discontinuous effects by an obstructed arterial tree. Conclusion Healthy persons cannot be well differentiated from PAOD-patients solely by hemodynamics at rest but by characteristic changes after standard exercise. Treatment effects are reflected by higher PI-values after exercise.


2019 ◽  
Vol 21 (3) ◽  
pp. 288
Author(s):  
Hyun Gi Kim ◽  
Jang Hoon Lee

Aims: The aim of this study was to compare the performances of Ultrafast Doppler ultrasound (US) with classic Doppler US, for cranial ultrasound in neonates.Materials and methods: We measured the peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI) of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) in neonates using both conventional and Ultrafast Doppler US and acquisition times were compared. Distal ACA branches were assessed with Ultrafast Doppler US.Results: A total of 138 neonates were included. The PSV and EDV of the cranial arteries were comparable between the two Doppler methods (PSV, 64.6-85.5 cm/s vs. 63.4-84.1 cm/s, p=0.100-0.510; EDV, 19.1-26.5 cm/s vs. 17.8-24.2 cm/s, p=0.100-0.981). The RIs of the ACA and PCA were not significantly different (0.69-0.73 vs 0.68-0.74, p=0.174-0.810). Ultrafast Doppler US required shorter acquisition times than conventional Doppler US (6.7 s vs. 11.0 s, p=0.003). The PSV and EDV of the distal ACA were higher than the proximal ACA (20.1-63.3 cm/s vs. 9.4-36.7, p<0.001) although the RI was similar (0.69 vs. 0.68, p=0.251).Conclusions: Ultrafast Doppler US provides comparable values to conventional Doppler US with shorter acquisition times. This novel imaging technique provides quantitative information and is suitable for distal cranial artery evaluation.


2021 ◽  
pp. 039156032110690
Author(s):  
Satyadeo Sharma ◽  
Rajendra K Shimpi

Introduction: Varicocele is among the most frequently encountered, surgically correctable causes of male infertility. Since varicocele is a primary abnormality of testicular vessels, a thorough understanding of haemodynamic changes in the microcirculation of varicocele testis is needed. Objectives: To estimate changes in the microcirculation of varicocele testis and correlate them with symptomatic and semen parameters changes before and after varicocelectomy. Material and methods: This prospective, observational study includes 47 patients of age group 18–40 years who underwent microsurgical varicocelectomy during June 2016 to April 2018 at a tertiary medical institute. Testicular haemodynamic was evaluated using a colour spectral doppler study (PSV-Peak systolic velocity/ESV-End diastolic velocity/RI-Resistive index/PI-Pulsatility index). Semen analysis parameters and testicular blood flow were compared with pre-operative values. Results: RI in the capsular artery of varicocele affected testis, which was 0.61 ± 0.11 (mean ± SD), significantly reduced to 0.56 ± 0.09 (mean ± SD) in post-operative follow-up, indicating improved perfusion. Pre-operative sperm density was noted to be 15.94 ± 7.88 (mean ± SD), which improved to 28.41 ± 10.99, Progressive sperm motility from 33.81 ± 10.88 to 38.32 ± 9.21 and morphology from 36.13 ± 10.68 to 41.43 ± 9.29 on 6-month follow-ups ( p < 0.05). Conclusion: Varicocele testis is associated with altered testicular haemodynamic, which insults spermatogenesis. Microsurgical varicocelectomy with testicular artery and lymphatic preservation leads to correction of this altered haemodynamic state and improves the testicular microcirculation.


2018 ◽  
Vol 12 (3) ◽  
pp. 634-638 ◽  
Author(s):  
Ozan Efesoy ◽  
Selahittin Çayan ◽  
Erdem Akbay

Hypogonadism may cause veno-occlusive dysfunction (VOD) by structural and biochemical alterations in the cavernosal tissue. The aim of the study was to investigate the effect of testosterone replacement therapy (TRT) on penile hemodynamics in hypogonadal men with erectile dysfunction and VOD. The study included 32 hypogonadal men with erectile dysfunction, having VOD. All patients underwent penile color Doppler ultrasonography (PCDU) at the beginning and 6 months after the initial evaluation. Erectile function was evaluated with the 5-item version of the International Index of Erectile Function (IIEF-5); hypogonadism was evaluated by testosterone measurement and the Aging Male Symptoms (AMS) scale. All patients received transdermal testosterone 50 mg/day for 6 months. Clinical and radiological findings were compared before and 6 months after the TRT. The mean age was 58.81 ± 4.56 (52–69) years. Mean total testosterone levels were 181.06 ± 39.84 ng/dL and 509.00 ± 105.57 ng/dL before and after the therapy, respectively ( p < .001). While all patients had physiological serum testosterone levels (>320 ng/dL) after the therapy, three cases (9.3%) had no clinical improvement of hypogonadism symptoms. Cavernosal artery peak systolic velocity (PSV) and resistive index (RI) significantly increased, and end diastolic velocity (EDV) significantly decreased after TRT. VOD no longer existed in 21 (65.6%) of the cases. This study demonstrated that TRT may restore penile hemodynamics in hypogonadal men with VOD.


2019 ◽  
Vol 97 (Supplement_3) ◽  
pp. 137-138
Author(s):  
Allison M Meyer ◽  
Natalie B Duncan ◽  
Katy S Stoecklein ◽  
Emma L Stephenson

Abstract To determine parity effects on late gestational uteroplacental blood flow, uterine artery hemodynamics were measured in 13 primiparous and 11 multiparous (parity 3 and 4) non-lactating, fall-calving crossbred females beginning 109 d prepartum. Females were nutritionally managed as one group to meet or exceed nutrient requirements. Transrectal color Doppler ultrasonography of the both uterine arteries was conducted 3 to 6 times per female across late gestation, ending at approximately 20 d prepartum. Data were analyzed with parity (primiparous vs. multiparous), day prior to calving, and their interaction in the model; day was a repeated effect. Dam BW was greater (P &lt; 0.001) for multiparous than primiparous females, and increased (P = 0.004) as gestation progressed. Calf birth weight was unaffected (P = 0.87) by parity. The parity x day interaction tended to affect (P = 0.06) ipsilateral uterine artery blood flow (L/min), where multiparous cows had a greater increase per day. Total and contralateral uterine artery blood flow were unaffected (P ≥ 0.11) by parity, but increased (P &lt; 0.001) with day of gestation. When expressed relative to dam BW, total and contralateral blood flow were greater (P ≤ 0.04) in primiparous than multiparous females; ipsilateral blood flow was unaffected (P ≥ 0.13) by parity, however. Ipsilateral pulsatility index and both resistance indices were unaffected (P ≥ 0.28) by parity and day, but day tended to affect (P = 0.07) contralateral pulsatility index. Parity did not affect (P ≥ 0.11) cross-sectional area, mean velocity, peak systolic velocity, and end diastolic velocity of either uterine artery, but all increased (P &lt; 0.001) as gestation progressed. Heart rate was greater (P = 0.03) in primiparous than multiparous females. Data suggest that uterine artery blood flow and heart rate may be altered in primiparous females, even when birth weight is unaffected by parity.


2019 ◽  
Vol 20 (2) ◽  
pp. 87-91
Author(s):  
Sohely Sultana ◽  
Tarana Yasmin ◽  
Md Nazir Uddin Mollah ◽  
Shyamal Kumar Roy ◽  
Mohammad Sazzad Hossain ◽  
...  

Background: Duplex Colour Doppler Sonography is gaining increasing popularity for assessment of blood vessels in various disease processes around the world as well as for the surveillance of fetus compromised by intra uterine growth retardation (IUGR) and to assess foetal structural abnormalities and complex disease processes. Materials & methods: This cross sectional study was carried out to observe Doppler wave form in subjects with preeclampsia enrolling 40 subjects with preeclampsia, in the Department of Radiology and Imaging, Dhaka Medical College Hospital, Dhaka, over a period of six months from 20th May 2012 to 19th November 2012. A total number of 40 normal pregnancies were also included for comparison. Peak systolic velocity (PSV), end diastolic velocity (EDV), Resistive index (RI), Pulsatility index (PI) in different groups of study subjects from 24th to 37th weeks were observed and compared for any significant differences. Results: Majority (35% in normal and 37.5% in preeclampsia) of the respondents were found in the age group of 21-30 years. Unpaired t-test revealed no significant difference between mean age between two groups. Among normal group, mean±SD PSV, EDV, PI and RI were 43.94±15.41 cm/sec and 15.51 (±4.93) cm/sec, 1.12±0.0846 and 0.571 (±0.058) respectively. Mean PSV, EDV, PI and RI were 83.19±18.44 cm/sec, 11.86±5.19 cm/sec, 2.497±0.369 and 0.8255±0.087 in preeclampsia group. There was statistically significant (By unpaired ttest) difference in mean Doppler indices between these two groups. It was observed that early diastolic notch was found in 90% subjects with preeclampsia. Early diastolic notch was observed in Doppler wave form in 5% subject with normal pregnancy. Chi-square test showed that there was statistically significant difference in presence of early diastolic notch between normal subjects and subjects with preeclampsia. Conclusions: From the study result it was concluded that Doppler indices with presence of early diastolic notch are reliable indicators for early detection of preeclampsia. J MEDICINE JUL 2019; 20 (2) : 87-91


2013 ◽  
Vol 5 (2) ◽  
pp. 147-153 ◽  
Author(s):  
S Sood ◽  
Subina Narang ◽  
S Kocchhar ◽  
S Sarda ◽  
S Aggarwal ◽  
...  

Introduction: Color Doppler Imaging (CDI) is used widely to study retrobulbar circulation. Objectives: To determine the association between progression of diabetic retinopathy (DR) and alterations in retrobulbar arterial circulation using CDI studies. Materials and methods: Prospective observational case series. It is single institutional study of 50eyes of nonproliferative diabetic retinopathy in 50 patients with type II diabetes mellitus. DR was graded according to ETDRS system. Retrobulbar circulation was studied in patients for Peak systolic velocity (PSV), End diastolic velocity (EDV) and Resistive index (RI) in Central retinal artery (CRA), Ophthalmic artery (OA) and Posterior ciliary artery (PCA) using CDI initially and reevaluated after 6 months or later for any change in retinopathy grade and arterial circulation parameters. The patients were grouped as Group I not showing progression of DR and Group II showing progression. The two groups were compared for any significant change in CDI parameters. Results: The baseline resistive indices were higher than normal population. There was significant increase in RI in PCA and CRA in all patients after 6 months. 14 patients (28%) showed progression of DR and 36 (72%) did not show progression of DR. There was no significant association with progression of retinopathy and CDI findings. (p=>0.05). Conclusion: The retrobulbar arterial circulation seems to be affected in all diabetics with DR. The changes appear to be progressive. The CDI findings in arterial circulation however lack predictive power for progression of diabetic retinopathy in non proliferative DR. Nepal J Ophthalmol 2013; 5(10): 147-153 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8705


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