[Correlation between findings of CT pulmonary angiography and outcome of diseases in patients with acute pulmonary embolism]

Background and Objectives: right ventricle failure and massive pulmonary artery occlusion are the main causes of mortality in patients with acute pulmonary embolism. Although pulmonary CT angiography could be helpful in these patients there are some controversies. In current study we want to investigate correlation between pulmonary artery obstruction score and right ventricular dysfunction with mortality rate in patients with acute pulmonary embolism

Methods and Materials: pulmonary CT angiography of 76 patients with acute pulmonary embolism and no previous comorbidity were reviewed at this prospective study. Maximum short axis dimensions of the right ventricle [RVD] and the left ventricle [LVD] and their ratio were measured. The pulmonary artery obstruction score [PAOS] was determined according to Qanadli. At the end the correlation between these findings and mortality at first 60 days were evaluated

Results: the 60-days mortality rate was 19.7%. The expired and survived groups were comparable for PAOS, whereas both the median age and RVD/LVD ratio were significantly higher in the first group. In multivariate analysis, however, age was the only significant, independent predictor of 60-day mortality [p=0.02]

Conclusion: without pre-existing morbidities, neither the RVD/LVD ratio nor PAOS is not an independent predictor of mortality in hemodynamically stable patients with acute PE

[Comparison of the findings of transvaginal ultrasound [after bowel preparation] and laparoscopy in the diagnosis of deep infiltrative endometriosis in Al-Zahra Infertility Clinic patients in Tabriz in 2013]

Background and Aim: Endometriosis is a common gynecological problem. In recent years, it has been one of the main subjects of women's diseases. 5-15% of the premenopausal women are suffering from this disorder. During the past two decades, its incidence has been on the rise

Material and Methods: This study was a retrospective study and included 60 patients with clinically suspected endometriosis who were candidates for laparoscopy. Transvaginal ultrasound and laparoscopy was performed for all of them. Data were collected using SPSS version 20 software and analyzed by sensitivity, specificity, positive predictive value, negative predictive value, and chi-square

Result: In this study the mean age of the patients was 31.1 +/- 4.97. We found a sensitivity of 100% for transvaginal ultrasound in the diagnosis of pelvic mass. The sensitivity and specificity of transvaginal ultrasound for the diagnosis of the bladder involvement were 50% and 100% respectively. The accuracy of the test to distinguish the two cases were 100% and 93%, respectively

Conclusion: The results of this study showed that the transvaginal ultrasound can be safely used for the diagnosis of pelvic mass and its diagnostic value is equal to that of laparoscopy. It is less invasive and less expensive than laparoscopy. We obtained satisfactory results by using transvaginal method for detection of bladder involvement

Hepatic artery and portal vein doppler indexes in non-alcoholic fatty liver disease before and after treatment to prevent unnecessary health care costs

We tested whether hepatic haemodynamics assessed by Doppler ultrasonography can be a predictor of response to therapy in patients with non-alcoholic fatty liver disease [NAFLD] to prevent further unnecessary diagnostic tests and interventions. Forty eight consecutive patients affected by NAFLD, who refered to some clinics in Tabriz, Iran between 2009 and 2011 were included in the study. Response to therapy was assessed by decrease in liver enzyme levels. Three liver Doppler parameters [hepatic artery resistance index [RI], hepatic artery pulsatility index [PI] and portal vein waveform [PVW]] were analysed in all subjects who showed a decrease in liver function tests results. Wilcoxon and paired student's /-test were used for analysis. Forty eight subjects with NAFLD were included in the study during 21 months, out of which 22 [39.1% male - mean age: 37.6 +/- 8.3] responded to the treatment and formed the basis of this study. Mean hepatic artery RI increased significantly from 0.60 +/- 0.07 to 0.83 +/- 0.27before and after treatment, however, there was no significant differences between hepatic artery PI or PVW. Increase in hepatic artery RI assessed by Doppler ultrasound may provide information on improvement of NAFLD in patients during the course of therapy

Postnephrectomy changes in doppler indexes of remnant kidney in unrelated kidney donors

We aimed to evaluate the intralobar renal arteries indexes using the Doppler ultrasonography indexes, which have become the established method of kidney monitoring, in living unrelated kidney donors during the postnephrectomy period. In this prospective study, we evaluated and followed up 34 living unrelated kidney donors. The Doppler ultrasonography indexes, including resistive index, pulsatility index, and peak systolic velocity, along with the grey-scale ultrasonographic indexes of cortical thickness, length, and anteroposterior diameter of the kidney were determined before nephrectomy, and then, 1 week and 3 months after nephrectomy. In addition, glomerular filtration rate were assessed simultaneously. The resistive index and pulsatility index did not change 1 week and 3 months after nephrectomy [P = .66 and P = .38, respectively]. The peak systolic velocity at 1 week was significantly higher than its prenephrectomy value [P = .02]. Also, the peak systolic velocity at 3 months was significantly higher than that prior to nephrectomy [P < .00 1]. Indexes of the kidney size all increased during the follow-up period. The estimated glomerular filtration rate increased decreased 1 week after nephrectomy, but it reach to a level comparable with its preoperative values after 3 months. Results of the present study showed an increased peak systolic velocity in association with unaltered resistive index and pulsatility index in the remnant kidney of donors, during the short-term follow-up. This finding indicates the increased blood flow and kidney size in the remnant kidney of donors, following nephrectomy

Doppler ultrasonographic indeces in kidney transplant recipients its relationship with kidney function

Doppler ultrasonography [DU] is mostly used for assessment of both graft and native kidneys' vascular status. In this study, correlation between the DU indexes and kidney allograft function was evaluated. Hospital records of 273 kidney transplant patients [154 men and 119 women] were reviewed. In all cases, DU had been performed 1 month after kidney transplantation. We evaluated the data on the resistive index [RI] and pulsatility index [PI] in the interlobar arteries and renal artery stenosis [RAS], and renal vessels thrombosis were determined. Concurrent serum creatinine and cyclosporine values were assessed in relation to the DU findings. The RI and PI had significant linear correlations with serum creatinine [P = .03 and P = .002, respectively]. Also, there were direct linear correlations between the age of the patients and the RI and PI values. The frequency of RAS was 10.3%. In patients with RAS, the mean creatinine level [2.08 +/- 1.70 mg/dL] was significantly higher than that in patients without RAS [1.48 +/- 0.97 mg/dL; P = .004]. Despite this finding, RI and PI were significantly lower in patients with RAS than in the patients with patent renovascular tributary [0.59 +/- 0.15 versus 0.65 +/- 0.11; P = .03 and 1.02 +/- 0.40 versus 1.18 +/- 0.46; P = .049, respectively]. There were no associations between serum cyclosporine level or panel reactive antibodies and the RI or PI. The RI and PI are valuable DU markers for determining the kidney allograft function and the related vascular complications