Features of regional blood flow after endoscopic myomectomy

The state of regional blood flow in 65 patients before and after endoscopic myomectomy was studied using modem methods such as Doppler examination and color Doppler sonography. It was determined that blood flow velocity indeces obtained during the Doppler examination of myoma vessels and uterine arteries allow to estimate the morphological structure of myomas uninvasively and can be used to define the indications for conservative endoscopic surgical procedures in patients with myoma uteri. Doppler monitoring of regional blood flow during postoperative period makes it possible to evaluate the effectiveness of surgical treatment previously performed.

The value of multimodal ultrasonography in differential diagnosis of tuberculous and non-tuberculous superficial lymphadenitis

Background To investigate the value of multimodal ultrasonography in differentiating tuberculosis from other lymphadenopathy. Methods Sixty consecutive patients with superficial lymphadenopathy treated at our hospital from January 2017 to December 2018 were categorized into four types based on the color Doppler ultrasound, five types based on contrast-enhanced ultrasound, and five types based on elastography. Sensitivity and specificity were calculated of all the three imaging, including color Doppler examination, contrast-enhanced ultrasound and one individual multimodal method, for detecting lymph nodes. Results A total of 60 patients were included in the final analysis. Of those, Mycobacterium tuberculosis was positive in 38 patients and negative in 22 patients. Among the 38 patients who were positive for Mycobacterium tuberculosis, of which 23 had a history of pulmonary tuberculosis, accounting for 60.53% of the positive cases, and the remaining patients did not combine lesions of other organs. Among the 60 superficial lymph nodes, 63.3% presented with tuberculous lymphadenitis. The sensitivity, specificity, and accuracy of the color Doppler examination were 73.68%, 68.18%, and 71.67%, respectively. The sensitivity, specificity and accuracy of contrast-enhanced ultrasound were 89.47%, 63.64% and 80.00%, respectively. The sensitivity, specificity and accuracy of the elastography were 63.16%, 63.64% and 63.33%, respectively. The sensitivity, specificity and accuracy of one individual multimodal method were 42.11%, 95.45% and 61.67%, respectively. The sensitivity, specificity and accuracy of all modes combined were 100.00%, 27.27% and 73.33%, respectively. Conclusion Multimodal ultrasonography has high predictive value for the differential diagnosis of superficial tuberculous lymphadenitis.

Doppler Ultrasonography of the Fetal Tibial Artery in High-Risk Pregnancy and Its Value in Predicting and Monitoring Fetal Hypoxia in IUGR Fetuses

Background and Objectives: Intrauterine growth restriction (IUGR) is the term used to describe a fetus whose estimated weight is less than the 10th percentile of its age growth curve. IUGR is the second most common cause of perinatal death. In many cases there is a deficiency in the standardization of optimal management, prenatal follow-up and timing of delivery. Doppler examination is the most sensitive test that can assess the condition of the fetus and indicate fetal intrauterine hypoxia. Numerous studies of the fetal intrauterine state focus on the umbilical artery and the fetal cerebral blood vessels, while the peripheral arteries have so far received insufficient attention. Materials and Methods: We present a case of an IUGR fetus monitored with a non-stress test (NST) and a Doppler examination of the fetal arteries (tibial, umbilical, middle cerebral and uterine) and the ductus venosus. In this case the first early sign of fetal hypoxia was revealed by blood flow changes in the tibial artery. Results: We hypothesize that peripheral vascular changes (in the tibial artery) may more accurately reflect the onset of deterioration in the condition of the IUGR fetus, such that peripheral blood flow monitoring ought to be employed along with other techniques already in use. Conclusion: This paper describes the clinical presentation of an early detection of late IUGR hypoxia and claims that blood flow changes in the tibial artery signal the worsening of the fetus’s condition.

Level of Agreement Between Systematic Doppler Examination of the Lower Extremity and Diagnostic Angiography in the Setting of Peripheral Arterial Disease

Background The objective of this investigation was to determine the level of agreement between a systematic clinical Doppler examination of the foot and ankle and diagnostic peripheral angiography. Methods The described Doppler examination technique attempted to determine the patency, quality, and direction of the flow through the dorsalis pedis artery, posterior tibial artery, terminal branches of the peroneal artery, and vascular arch of the foot. These results were then compared with angiographic distal run-off images as interpreted by a blinded vascular surgeon. Results Levels of agreement with respect to artery patency/quality ranged from 64.0% to 84.0%. Sensitivity ranged from 53.8% to 84.2%, and specificity ranged from 64.7% to 91.7%. Agreement with respect to arterial flow direction ranged from 73.3% to 90.5%. Conclusions We interpret these results to indicate that this comprehensive physical examination technique of the arterial flow to the foot and ankle with a Doppler device might serve as a reasonable initial surrogate to diagnostic angiography in some patients with peripheral arterial disease.

Prevention of primary placental dysfunction with low location of the chorion

Objective is to develop new methods to prevent primary placental dysfunction (PD) in early gestational age with low placentation.Material and methods. We have examined 119 pregnant women with low placentation. This diagnosis was made from 6-7 weeks of gestation on the basis of echographic research. The main group consisted of 64 pregnant women with low chorionic location, which was used to prevent PD from the early gestational age by the complex of medicines developed by us and a control group of 55 women with low placentation that had not undergone PD prophylaxis from early gestational periods. The treatment and prophylactic complex included: Luteina, ginkgo biloba extract, folio and biolectra. In the main and control groups, all pregnant women underwent Doppler examination in the uterine and spiral arteries, as well as determined the volume of the chorion and the volume of blood flow in the chorion.Results. Doppler examination in the main group showed a decrease in all indices of resistance in the uterine and spiral arteries, as well as a significant increase in chorionic volume and vascularization index in three-dimensional ultrasound compared with the control group.Conclusions. The proposed treatment and prophylactic complex agents (Luteina, ginkgo biloba extract, folio and biolectra) helps to normalize uterine-chorionic blood flow, restore effective embryo-chorionic relationships and significantly reduces the frequency of further development of primary placental dysfunction in pregnant women with low-grade pregnancy.

Uterine Artery Doppler Ultrasonography for First Trimester Prediction of Preeclampsia in Individuals at Risk from Low-Resource Settings

Background and objectives: The objective of this study was to evaluate the potential of first trimester uterine artery Doppler ultrasonography for the early prediction of preeclampsia (PE), in at-risk pregnant women. Materials and Methods: This was a prospective longitudinal study, including 120 Caucasian pregnant women with risk factors for PE. The potential of pulsatility indexes (PI) and notch was assessed as a tool for preeclampsia screening. Results: Doppler examination of the uterine artery performed early at 11–14 WA allows the detection of pregnancies that will develop PE with a sensitivity of 61.5% and a specificity of 63.8% based on PI analysis. Predictive power increases slightly by adding bilateral notch (sensitivity = 65.4%; specificity = 66%). Conclusions: Uterine artery Doppler examination is an effective non-invasive screening test for the development of PE in pregnancies at risk, particularly appropriate in health systems with limited means of evaluating other biomarkers.

First trimester fetal heart evaluation. A pictorial essay

Classically fetal heart evaluation is mandatory in the second trimester of pregnancy. Recent data suggest that the diagnosis of congenital heart disease is feasible in the first trimester (FT) of pregnancy, especially for trained examiners. In this pictorial essay we aim to illustrate in detail the particularity of the FT heart evaluation: the specific ultrasound techniques including practical tips for the basic and extended first trimester fetal heart evaluation protocol. The diagnosis is possible by the use of a variety of ultrasound techniques (B mode, CFM, Bidirectional Doppler, STIC, TUI) using the transabdominal/transvaginal probes. An abnormal FT heart scan requires second trimester reassessment. Unfortunately, not all cardiac disease can be potentially diagnosed in the first trimester. Based on their own experience the authors recommend that heart examination in the FT should be attempted in all fetuses, even in low risk pregnancies, using at least the basic Doppler examination protocol.

Ultrasonography findings in immunoglobulin G4-related lymphadenopathy: a report of two cases

Lymphadenopathy is frequently observed in immunoglobulin G4 (IgG4)-related disease in some cases, and such cases are known as IgG4-related lymphadenopathy. The ultrasonography findings associated with IgG4-related lymphadenopathy have not been described in previous reports. Herein, we describe ultrasonography findings in two cases of IgG4-related lymphadenopathy in conjunction with histopathological findings. Combined ultrasound scanning with Doppler examination accurately represented the specific histopathological features of IgG4-related lymphadenopathy.