Uterine Artery Doppler Velocimetry of Uterine Leiomyomas in Nigerian Women / Dopplervelocimetria da artéria uterina de leiomiomas uterinos em mulheres nigerianas

Abstract Objective To describe the blood flow velocities and impedance indices changes in the uterine arteries of leiomyomatous uteri using Doppler sonography. Methods This was a prospective, case-control study conducted on 140 premenopausal women with sonographic diagnosis of uterine leiomyoma and 140 premenopausal controls without leiomyomas. Pelvic sonography was performed to diagnose and characterize the leiomyomas. The hemodynamics of the ascending branches of both main uterine arteries was assessed by Doppler interrogation. Statistical analysis was performed mainly using non-parametric tests. Results The median uterine volume of the subjects was 556 cm3, while that of the controls was 90.5 cm3 (p < 0.001). The mean peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (TAMX), time-averaged mean velocity (Tmean), acceleration time (AT), acceleration index (AI), diastolic/systolic ratio (DSR), diastolic average ratio (DAR), and inverse pulsatility index (PI) were significantly higher in the subjects (94.2 cm/s, 29.7 cm/s, 49.1 cm/s, 25.5 cm/s, 118 ms, 0.8, 0.3, 0.6, and 0.8 respectively) compared with the controls (54.2 cm/s, 7.7 cm/s, 20.0 cm/s, 10.0 cm/s, 92.0 ms, 0.6, 0.1, 0.4, and 0.4 respectively); p < 0.001 for all values. Conversely, the mean PI, resistivity index (RI), systolic/diastolic ratio (SDR) and impedance index (ImI) of the subjects (1.52, 0.70, 3.81, and 3.81 respectively) were significantly lower than those of the controls (2.38, 0.86, 7.23, and 7.24 respectively); p < 0.001 for all values. Conclusion There is a significantly increased perfusion of leiomyomatous uteri that is most likely due to uterine enlargement.

Resumo Objetivo Descrever as velocidades do fluxo sanguíneo e as alterações dos índices de impedância nas artérias uterinas leiomiomatoso utilizando a ultrassonografia Doppler. Métodos Estudo prospectivo, caso-controle, realizado em 140 mulheres pré-menopáusicas com diagnóstico ultrassonográfico de leiomioma uterino e em 140 controles na pré-menopausa sem leiomiomas. A ultrassonografia pélvica foi realizada para diagnosticar e caracterizar os leiomiomas. A hemodinâmica dos ramos ascendentes de ambas as artérias uterinas principais foi avaliada por meio de interrogatório Doppler. A análise estatística foi feita principalmente por meio de testes não paramétricos. Resultados A média do volume uterino dos das pacientes foi de 556 cm3, enquanto a dos controles foi de 90,5 cm3 (p < 0,001). A média de velocidade de pico sistólico (VPS), a velocidade diastólica final (VDF), a velocidade máxima do tempo médio (VMTM), a velocidade média do tempo médio (VMdTM), o tempo de aceleração (TA), o índice de aceleração (IA), a relação diástole/sístole (RDS), a proporção diastólica média (PDM) e o índice de pulsatilidade (IP) inversa foram significativamente maiores em pacientes (94,2 cm/s, 29,7 cm/s, 49,1 cm/s, 25,5 cm/s, 118 ms, 0,8, 0,3, 0,6 e 0,8, respectivamente) do que nos controles (54,2 cm/s, 7,7 cm/s, 20,0 cm/s, 10,0 cm/s, 92,0 ms, 0,6, 0,1, 0,4 e 0,4, respectivamente); p < 0,001 para todos os valores. Por outro lado, o IPmédio, o índice de resistividade (IR), a relação sístole/diástole (RSD) e o índice de impedância (II) nas pacientes (1,52, 0,70, 3,81 e 3,81, respectivamente) foram significativamente mais baixos do que os dos controles (2,38, 0,86, 7,23 e 7,24, respectivamente); p < 0,001 para todos os valores. Conclusão Existe um aumento significativo da perfusão dos úteros leiomiomatosos, que provavelmente se deve ao alargamento uterino.

Ocular blood flow velocity in primary open angle glaucoma - a tropical african population study

To assess blood flow velocity in newly diagnosed indigenous black- skinned Africans with primary open angle glaucoma [POAG]. Prospective case-control study at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria on 50 newly diagnosed POAG patients [POAG group] and 50 control patients [control group]. Ocular Doppler Color Imaging was performed on subjects in the supine position using 9 MHz linear array transducer of a Fukuda Denshi Ultrasound, The Peak Systolic Velocity [PSV] and End Diastolic Velocity [EDV] values were obtained by finding the average of two readings each for the ophthalmic artery [OA] and central retinal artery [CRA]. Resistive Index [RI] was calculated as [PSV - EDV]/PSV Data were analyzed and statistical significance was defined at P< 0.05. The mean intraocular pressure [IOP] for the POAG group and control group was 28.1 +/- 7.4 mmHg and 16.6 +/- 2.0 mmHg, respectively [P< 0.001]. The mean PSV for OAwas 31.35 cm/s in POAG group and 37.61 cm/s for the control group [P< 0.001]. The EDV for both OA and CRA were significantly lower in glaucoma patients as compared with the corresponding values in the control group [P< 0.001, both comparisons]. The mean RI in the OA was 0.71 +/- 0.05 and 0.63 +/- 0.03 for the POAG and control group groups, respectively [P < 0.001]. The increase in IOP in the POAG group was statistically significantly negatively correlated with PSV and EDV and positively correlated with RI for both OA and CRA. The outcomes of this study indicate that ocular blood flow alterations including reductions in PSV and EDV and increase in RI of the OA and CRA are present in black- skinned Africans with POAG