Indications et résultats de l'échographie doppler vasculaire à Cotonou : à propos de 73 cas

Objectif : Décrire les indications et les résultats de l'échographie Doppler vasculaire en pratique de ville à Cotonou au Bénin. Matériels et Méthodes : Une étude rétrospective et descriptive a été menée sur les archives des comptes rendus d'échographie Doppler vasculaire d'octobre 2015 à juin 2018, soit une période de 33 mois dans l'unité d'échographie du Centre d'Imagerie Médicale et de Diagnostic. Tous les patients ayant fait une échographie Doppler vasculaire dans la période ont été inclus dans l'étude. Les variables étudiées étaient l'âge et le sexe, les indications cliniques, la région anatomique examinée et les lésions retrouvées à l'échographie Doppler vasculaire. Résultats : 73 patients ont été inclus. L'âge moyen des patients était de 54,30 ans ± 11,58. Les patients étaient en majorité de sexe masculin (54,79%) avec une sex-ratio M/F égale à 1,21. L'indication de l'échographie Doppler vasculaire était pertinente dans 100% des cas. Les indications les plus fréquentes étaient le pied diabétique (32,88%), la suspicion de thrombose veineuse profonde (19,18%), les grosses jambes douloureuses (12,33%) et les œdèmes des membres pelviens (9,59%). L'échographie Doppler vasculaire des membres pelviens représentaient 93,11% des examens. 54 examens (73,97%) étaient revenus pathologiques. Les pathologies vasculaires les plus rencontrées étaient l'artériopathie calcifiante des membres pelviens (27,78%), l'insuffisance veineuse (18,51%) et la thrombose veineuse profonde (16,67%). Conclusion : L'échographie Doppler vasculaire réalisée par un spécialiste est performante dans le diagnostic des pathologies vasculaires périphériques. Elle constitue une alternative pertinente et peu onéreuse d'exploration vasculaire dans les pays à ressource limitée. Dans le contexte d'émergence des maladies cardio-vasculaires dans ces pays, elle mérite d'être vulgarisée dans les centres publiques et privées

Avaliação do fluxo de saída do ventrículo esquerdo em gatos anestesiados submetidos ao pneumoperitônio e à posição deTrendelenburg / Evaluation left ventricle Outflow in cats anesthetized submitted to pneumoperitoneum and Trendelenburg position

Objetivou-se avaliar os efeitos do pneumoperitônio e da posição de Trendelenburg sobre o fluxo de saída do ventrículo esquerdo em gatos anestesiados. Quatorze gatos foram alocados aleatoriamente em dois grupos, ambos submetidos ao pneumoperitônio com 10mmHg de dióxido de carbono (CO2). No grupo controle (GC n=7), os animais foram submetidos apenas ao pneumoperitônio e, no grupo Trendelenburg (GTREN n=7), os animais foram colocados em cefalodeclive 20° após o pneumoperitônio. A indução anestésica foi realizada com isoflurano, utilizando-se caixa de indução. Posteriormente, os animais foram mantidos sob anestesia inalatória com o mesmo fármaco. Foram avaliados a velocidade do fluxo de saída do ventrículo esquerdo (VFSVE), os gradientes máximo (GmáxSVE) e médio (GmédSVE) de pressão e a integral velocidade-tempo (IVT). Os parâmetros foram mensurados nos momentos T0 (basal), antes da insuflação; T5 (cinco), T15 (quinze) e T30 (trinta) minutos após a insuflação. Os resultados mostraram um aumento da VFSVE no GC, em T15 e T30 (P=0,024), e um aumento do GmáxSVE no GC, em T30 (P=0,045). As variáveis não se alteraram significativamente em nenhum momento no GTREN. Dessa forma, conclui-se que a posição de Trendelenburg favoreceu o sistema cardiovascular, preservando os índices de fluxo sanguíneo na saída do ventrículo esquerdo.(AU)

The aim of this study was to evaluate the effects of pneumoperitoneum and Trendelenburg position on the left ventricular outflow in anesthetized cats. Fourteen cats were randomly divided into two groups, both submitted to pneumoperitoneum of 10 mmHg with carbon dioxide (CO2), and in the control group (GC n = 7) the animals were subjected only to pneumoperitoneum and the Trendelenburg group (n = 7 GTREN) the animals were placed in cefalodeclive 20° after pneumoperitoneum. Anesthesia of the animals was performed with isoflurane using induction box, keeping the animals under inhalation anesthesia with the same drug. We evaluated the speed of the left ventricular outflow (VFSVE), the maximum pressure gradient (GmáxSVE), mean pressure gradient (GmédSVE) and velocity-time integrals (IVT). The parameters were measured in time, T0 (baseline), before the insufflation; T5 (five); T15 (fifteen) and T30 (thirty) minutes after inflation. The results showed an increase in VFSVE in GC, T15 and T30 (p = 0,024) and an increase in GmáxSVE in GC in T30 (p = 0,045). The variables did not change significantly at any time in GTREN. Thus, it is concluded that the Trendelenburg position favored the cardiovascular system, preserving blood flow rates in the left ventricular outflow.(AU)

Portal Vein Dopplerflowmetry in healthy sheep according to age / Dopplerfluxometria da veia portal em ovinos hígidos de acordo com a idade

Pulsed Doppler ultrasound was used to evaluate portal blood flow, portal velocity and portal congestion index in 24 healthy sheep divided into groups (lambs, yearlings and ewes), according to age. Measurements were performed at the 11th right intercostal space using ideal insonation angle and uniform insonation method. Mean values obtained in each group were compared with one-way ANOVA, followed by Tukey post-hoc test. Portal velocity and portal blood flow were statistically similar between the groups (P>0.05). Mean portal velocity were 17.75; 17.13 and 16.75; while mean portal blood flow were 26.65; 31.04 and 24.32 for lambs, yearlings and ewes, respectively. Portal congestion index was statistically distinct between the groups and values for lambs, yearlings and ewes were 0.009; 0.058 and 0.09, respectively (P<0.01). Statistical differences were observed in portal vein diameter, portal vein area and portal congestion index between the groups, presumably due to influence of weight and not to age.(AU)

A ultrassonografia com Doppler pulsado foi utilizado para avaliar o fluxo sanguíneo portal, velocidade portal e índice de congestão portal em 24 ovinos saudáveis divididos em grupos (cordeiros, borregos e ovelhas), de acordo com a idade. As medições foram realizadas no 11o espaço intercostal direito utilizando ângulo de insonação ideal e método de inclusão uniforme. Os valores médios obtidos em cada grupo foram comparados com ANOVA, seguido pelo teste post-hoc de Tukey. A velocidade portal e o fluxo de sangue portal foram estatisticamente semelhantes entre os grupos (P>0,05). A velocidade portal média foram 17,75; 17,13 e 16,75; enquanto o fluxo de sangue portal médios foram 26,65; 31,04 e 24,32 para cordeiros, borregos e ovelhas, respectivamente. O índice de congestão portal foi estatisticamente diferente entre os grupos e os valores para cordeiros, novilhos e ovelhas foram 0,009; 0,058 e 0,09, respectivamente (P<0.01). Observaram-se diferenças estatísticas nos diâmetros da veia porta, na área da veia porta e nos índices de congestão portal entre os grupos, provavelmente devido à influência do peso e não pela idade.(AU)

Eliminação de Dioctophyme renale pela urina em canino com dioctofimatose em rim esquerdo e cavidade abdominal - Primeiro relato no Rio Grande do Sul / Elimination of Dioctophyme renale to urine in canines with dioctophymosis in the left kidney and abdominal cavity - First report in Rio Grande do Sul

Dioctophyme renale é um parasito que afeta tanto animais como humanos e tem como órgão de eleição o rim direito. Relata-se o caso clínico-cirúrgico de um paciente canino com histórico de eliminação de três exemplares de D. renale pela urina e presença de parasitos no rim esquerdo e na cavidade abdominal. No Hospital de Clínicas Veterinárias da Universidade Federal de Pelotas, foram realizados exames pré-cirúrgicos, entre eles a ultrassonografia abdominal, que identificou a localização dos nematódeos, e o exame de Doppler pulsado dos vasos intrarrenais, que demonstrou aumento nos índices resistivos nas regiões avaliadas. O paciente foi conduzido para a realização de laparotomia exploratória, sendo removidos 23 parasitos da cavidade abdominal. A presença de D. renale causa graves lesões nos rins e nos demais órgãos da cavidade abdominal, sendo essencial o diagnóstico precoce e a remoção dos nematódeos para recuperação do paciente.(AU)

Dioctophyme renale is a parasite that attacks animals as well as humans and has the right kidney as a preferred target organ. This document reports the case of a clinical-chirurgical canine patient with a history of elimination of three D. renale samples through its urine and presence of parasites at its left kidney and abdominal cavity. Pre-cirurgical exams were performed at the Veterinary Hospital of the Federal University of Pelotas. Among these exams, abdominal ultrasonography identified the nematode's location and the Pulse-Doppler of the intrarenal vessels showed an increase in the resistive indices of the evaluated areas. An Exploratory Laparotomy was conducted with the patient who had 23 parasites removed from its abdominal cavity. The presence of D. renale causes severe lesions at kidneys and other organs of the abdominal cavity, for this reason early diagnosis and nematode´s removal are essential for the patient's recovery.(AU)

Doppler ultrasonography of the lower extremity arteries: anatomy and scanning guidelines

Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography.

Atualização sobre ultrassom doppler das artérias vertebrais: síndrome do roubo da subclávia / An update on doppler ultrasound of vertebral arteries: subclavian steal syndrome

A síndrome do roubo da subclávia refere-se a uma desordem vascular na qual ocorre inversão do fluxo de sangue da artéria vertebral ipsilateral, decorrente de uma estenose proximal à sua origem, geralmente uma oclusão da artéria subclávia ou, mais raramente, do troncobraquiocefálico. É uma doença relativamente rara, relatadaem aproximadamente 6% dos pacientes assintomáticos com sopros cervicais. O Doppler pulsado (PW) é útil na análiseda artéria vertebral, registrando informações capazes de identificar a presença da Síndrome do Roubo da Subclávia. Com base nas alterações hemodinâmicas da artéria vertebralavaliadas pelo estudo com Doppler espectral, pode ser classificada nos tipos 1 (oculto), 2 (intermitente ou parcial)e 3 (completo). Com o advento da angioplastia transluminal percutânea e, em seguida, dos stents, muitos advogam essa combinação de procedimentos como o tratamento de escolha dos casos sintomático dessa síndrome.

Restricción selectiva del crecimiento intrauterino en la gestación gemelar monocorial: diagnóstico y manejo / Selective intrauterine growth restriction in monochorionic-diamniotic twins: diagnosis and management

La Restricción Selectiva del Crecimiento Intrauterino se produce en 10 a 19% de los gemelos monocoriónicos, y se asocia con un aumento importante de la mortalidad y la morbilidad perinatal. La evolución clínica está dada en gran parte por la presencia de anastomosis vaculares y la distribución placentaria asimétrica. Se propuso una clasificación en tres tipos según el Doppler de la arteria umbilical del gemelo más pequeño, la que sé que se correlaciona con distintos comportamientos clínicos y características de la placenta, lo que ayuda en el asesoramiento y conducta obstétrica. Los del tipo I tienen un pronóstico favorable por el resultado perinatal satisfactorio por lo que se recomienda un seguimiento cercano por ecografía y Doppler. Los de tipo II tienen un mal pronóstico y el tipo III un pronóstico intermedio e impredecible. En estos dos últimos se puede realizar un manejo expectante hasta que se observe deterioro del feto pequeño, considerando la posibilidad de la coagulación con láser o la oclusión del cordón (feticidio selectivo). Ambas conductas aparentemente aumentan las posibilidades de supervivencia del feto de peso normal.

Selective intrauterine growth restriction occurs in 10-19% of monochorionic twins, and is associated with increased mortality important and perinatal morbidity. The clinical course is given largely by the presence of placental vascular anastomosis and asymmetric distribution. It classified into three types according to the proposed Doppler umbilical artery smaller twin, the one that correlates with different clinical behaviors and characteristics of the placenta, which helps in counseling and obstetric conduct. The type I have a favorable prognosis for satisfactory perinatal outcome so closely monitored by ultrasound and Doppler is recommended. The type II has a poor prognosis and type III intermediate and unpredictable prognosis. In these last two you can make an expectant management until deterioration of the small fetus is observed, considering laser coagulation or cord occlusion (selective feticide). Both behaviors appear to increase the chances of survival of the fetus of normal weight.

Spleen evaluation using contrast enhanced ultrasonography and Doppler in dogs with subclinical ehrlichiosis / Ultrassonografia por contraste com microbolhas e Doppler na avaliação do baço de cães com erliquiose subclínica

The aim of this study was to evaluate the splenic parenchyma of dogs with subclinical ehrlichiosis using Doppler and contrast-enhanced ultrasonography and provide reference values for this organ in affected animals. Seventeen dogs naturally infected with E. canis were selected for this study. Splenic parenchyma echotexture and echogenicity, size and borders were determined by ultrasound scan. The vascular indices of the splenic artery were determined by Doppler. SonoVue, at 0.1mL per animal, was used in microbubble contrast-enhanced ultrasonography to determine wash in, wash out and peak enhancement time in the splenic tissue. B-mode ultrasonography revealed splenomegaly with rounded borders, heterogeneous echotexture and mixed echogenicity. The vascular indices of the splenic artery were: systolic velocity of 22.59±8.07cm/s, diastolic velocity of 5.25±4.66cm/s and resistance index of 0.71±0.14; values not yet reported in Veterinary Medicine. Contrast-enhanced ultrasonography recorded wash in time of 5.31±0.7s, peak enhancement time of 18.56±2.90s and wash out time of 94.56±35.21s. The combination of conventional ultrasonography of the spleen and hemodynamic evaluation by Doppler and contrast-enhanced ultrasonography is important for the diagnosis of canine ehrlichiosis and could help monitor the clinical evolution of subclinical cases.

O objetivo deste estudo foi avaliar o parênquima esplênico de cães com erliquiose na fase subclínica, por meio do Doppler e da ultrassonografia por contraste com microbolhas. Dezessete cães naturalmente infectados por E. canis na fase subclínica foram selecionados para este estudo. Por meio da ultrassonografia, avaliou-se a ecotextura, a ecogenicidade, o tamanho e os bordos do baço e, pelo Doppler, foram determinados os índices vasculares da artéria esplênica dos cães. Para a avaliação por contraste com microbolhas, foi utilizado SonoVue, na dosagem de 0,1mL por animal, e determinou-se o tempo de entrada e saída, bem como o pico de realce no tecido esplênico. Ao exame modo-B, foram observadas esplenomegalia com presença de bordas arredondadas, ecotextura heterogênea e ecogenicidade mista do baço. Ao Doppler, foram encontrados valores para os índices vasculares da artéria esplênica: velocidade sistólica: 22,59±8,07cm/s; velocidade diastólica: 5,25±4,66cm/s; e índice de resistência: 0,71±0,14, valores ainda não descritos em veterinária. Pela ultrassonografia com contraste, observaram-se valores para wash-in de 5,31±0.7s, pico de realce de 18,56±2.90s e wash-out de 94,56±35.21s. A ultrassonografia convencional do baço de cães com erliquiose, associada com a utilização do método Doppler e a ultrassonografia contrastada, é uma importante ferramenta na triagem diagnóstica e pode auxiliar a monitoração e a evolução de animais na fase subclínica.

Ultrassonografia modo B e Doppler na avaliação renal de cães após administração intravenosa de meio de contraste iodado: validação da técnica / B-mode and Doppler ultrasonography in the renal evaluation of dogs after intravenous administration of iodinated contrast media: technical validation

Meios de contraste iodado podem promover efeitos hemodinâmicos relacionados à vasoconstrição intrarrenal prolongada e redução da perfusão, predispondo à hipóxia e isquemia medular. Alterações de resistência vascular renal podem representar os primeiros sinais de mudança funcional desse órgão. A técnica Doppler pulsado é considerada acessível, não invasiva e permite avaliar a dinâmica vascular dos rins, por meio da aferição dos índices de resistividade (IR) e pulsatilidade (IP). Contudo, na espécie canina, a aquisição de traçados espectrais pode ser penosa devido às dificuldades de varredura e captação de sinal Doppler, sobretudo em relação ao rim direito, devido à sua localização dorsocranial na cavidade abdominal, o que prolonga substancialmente a realização do exame. O objetivo deste estudo é comprovar que a avaliação Doppler pulsado das artérias intrarrenais do rim esquerdo de cães representa a repercussão hemodinâmica renal da administração intravenosa de meios de contraste iodado não sendo necessária a realização do exame nos dois rins. Foram avaliados ambos os rins de seis cadelas adultas em quatro momentos distintos: antes da infusão intravenosa do contraste radiológico e após 1,5 horas, 24 horas e 48 horas, por meio da análise subjetiva da morfologia, ecogenicidade cortical e grau de perfusão renais e análise objetiva do comprimento, volume e resistência vascular intrarrenais (IR e IP). Os parâmetros avaliados ao modo B e Doppler dos rins direito e esquerdo não apresentaram diferenças estatisticamente significativas entre si em cada momento avaliado. Assim, constatou-se que o exame ultrassonográfico Doppler pulsado do rim esquerdo representou a repercussão hemodinâmica renal da aplicação intravenosa de meios de contraste iodado, desde que morfometria, morfologia, ecogenicidade cortical e perfusão de ambos os rins fossem consideradas semelhantes na abordagem ultrassonográfica inicial...

Iodinated contrast media can provide hemodynamic effects related to prolonged intrarenal vasoconstriction and reduced perfusion, predisposing to hypoxia and medular ischemia. Changes in the renal vascular resistance may represent the first sign of impaired renal function. Pulsed wave Doppler sonography is low cost, non-invasive and allows renal hemodynamic evaluation by resistivity (RI) and pulsatility (PI) indices. However in dogs, spectral Doppler waveform may be hard to obtain due to scanning difficulties and lack of signal Doppler. This fact occurs mostly in the right kidney because of its cranial and dorsal position in the abdominal cavity and may prolong the exam. The purpose of this study is to prove that the pulsed wave Doppler interrogation of the canine left kidney intrarenal arteries represent the renal hemodynamic effects of intravenous administration of iodinated contrast media and is not necessary to perform the exam in both kidneys. Right and left kidneys of six adult dogs were evaluated at four different times: before intravenous contrast infusion and after 1.5 hours, 24 hours and 48 hours, subjectively by using renal morphology, cortical echogenicity and renal perfusion, and objectively by using renal length, renal volume and intrarenal vascular resistance (RI and PI). No significant differences were noted between the parameters assessed by B mode and Doppler sonography of the right and left kidney in each evaluated moment. Thus, it was noted that pulsed wave Doppler sonographic evaluation of the left kidney represented the renal hemodynamic response of intravenous iodinated contrast media administration, only if both kidneys presented similar morphometry, morphology, cortical echogenicity, and perfusion during the first assessment...

Usefulness of resistive index on spectral Doppler ultrasonography in the detection of renal cell carcinoma in patients with end-stage renal disease

PURPOSE: The aim of this study was to explore the usefulness of the resistive index (RI) on spectral Doppler ultrasonography (US) in the detection of renal cell carcinoma (RCC) in patients with end-stage renal disease (ESRD). METHODS: Seventeen ESRD patients with kidneys in which renal masses were suspected in routine US were subjected. They underwent computed tomography scans and additional Doppler US for the characterization of the detected lesions. All underwent radical nephrectomy with the suspicion of RCC. Fourteen patients finally were included. RI measurements were conducted in the region of the suspected renal mass and the background renal parenchyma. The intraclass correlation coefficient was used to assess the reproducibility of the RI measurement. A paired t-test was used to compare the RI values between the renal mass and the background renal parenchyma (P<0.05). RESULTS: The RI values measured at the RCCs were significantly lower than those measured at the background renal parenchyma (0.41-0.65 vs. 0.75-0.89; P<0.001). The intrareader reproducibility proved to be excellent and good for the renal masses and the parenchyma, respectively (P<0.001). CONCLUSION: RI on spectral Doppler US is useful in detecting RCC in patients with ESRD. The RI values measured at the RCCs were significantly lower than those measured at the background renal parenchyma.

Venous Occlusion Detected by Caregiver with Implantable Doppler in a Buried Free Flap

The use of the implantable Doppler device eases the burden of free flap monitoring, and allows caregivers to notify healthcare personnel of a potential vascular event. A 24-year-old female patient underwent anterolateral thigh adipofascial flap surgery to provide a buried flap on the left temporal area for a depressed and infected skull wound. The author was able to salvage the flap from two venous occlusions, which was made possible by early notifications from the caregiver who reported changes in the Doppler signal.

Pulsed tissue Doppler imaging of the left ventricular septal mitral annulus in healthy dogs

This study evaluated pulsed TDI variables including the isovolumic time interval and duration of the major wave in a population of large healthy dogs. Longitudinal myocardial motion at the septal mitral annulus was evaluated with pulsed TDI in 45 healthy adult dogs. Maximal myocardial velocities, isovolumic time intervals, and duration of the myocardial waves were measured. The correlation between time intervals and velocity variables was also investigated. The mean maximal systolic velocity was 6.92 +/- 1.78 cm/sec, the mean early diastolic velocity (Em) was 6.58 +/- 1.81 cm/sec, the mean late diastolic velocity (Am) was 5.10 +/- 2.00 cm/sec, the mean isovolumic contraction time (IVCT) was 53.61 +/- 95.13 msec, and the mean isovolumic relaxation time (IVRT) was 26.74 +/- 57.24 msec. The early diastolic mitral inflow velocity (E)/Em ratio was 10.94 +/- 3.27 while the Em/Am ratio was 1.40 +/- 0.40. There was a negative correlation between Am duration and Am amplitude, and a positive correlation between the IVRT and Em/Am ratio (p < 0.05). The normal LV parameter using pulsed TDI method could be used as the reference range for identifying myocardial dysfunction in dogs.

Diagnostic value of ultrasonography in combination with mammography for breast cancer within 2 cm: a meta-analysis / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the diagnostic value of ultrasonography in combination with mammography for breast cancer within 2 cm.</p><p><b>METHODS</b>The PubMed, the Cochrane Library, CNKI, CBM and Wanfang databases (2003/01/01-2013/04/30) were searched for studies of the diagnostic value of ultrasonography in combination with mammography for breast cancer within 2 cm. The quality of the included studies was evaluated according to QUADAS items. The pooled sensitivity (SEN), pooled specificity (SPE), pooled diagnostic odds ratio (DOR), and area under summary receiver operating characteristic curve (AUC) were calculated using Review Manager 5.2 and Meta-DiSc 1.4 software.</p><p><b>RESULTS</b>Nine articles were included in the final analysis. The pooled SEN of ultrasonography, mammography and their combination were 0.75, 0.66, and 0.92, the pooled SPE 0.75, 0.83, and 0.82, the pooled DOR 7.11, 8.67, and 60.82, and the AUC 0.7902, 0.8120, and 0.9469, respectively.</p><p><b>CONCLUSION</b>The combination of ultrasonography and mammography can increase the diagnostic accuracy for breast cancer within 2 cm.</p>

Effect of ultrasound on osteoprotegerin and receptor activator nuclear factor kappaB ligand expression during root resorption in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of pulsed ultrasound on the expressions of osteoprotegerin (OPG) and receptor activator nuclear factor kappaB ligand (RANKL) during root resorption in a mouse model of orthodontic tooth movement.</p><p><b>METHODS</b>Thirty-two male Wistar rats (6-8 weeks old) were randomly assigned into 4 equal groups, including the blank control group, two ultrasound exposure groups with daily local LIPUS stimulation (100 and 150 MW/cm(2)) for 10 days during mechanical loading, and the control group with mechanical loading but not LIPUS exposure. Nickel-titanium closed-coil springs were used to generate 100 g mesial force for 10 days to move the maxillary right first molars. The expression of OPG and RANKL proteins at the compression sites was detected by immunohistochemistry.</p><p><b>RESULTS</b>Ultrasound stimulation significantly up-regulated the expression of OPG and down-regulated RANKL expression (P<0.05). The expressions of OPG and RANKL showed significant differences between the two ultrasound exposure groups (P<0.05).</p><p><b>CONCLUSION</b>Ultrasound stimulation might be useful to protect against root resorption and accelerate its repair by regulating the expressions of OPG and RANKL.</p>

Noise and speckle reduction in ultrasound Doppler blood flow spectrograms by using MP-PCNN / 生物医学工程学杂志

To reduce background noise and Dopplar speckle in the spectrogram of ultrasound Doppler blood flow signals, a novel method, called Matching Pursuit with threshold decaying pulse coupled neural network (MP-PCNN), has been proposed. The proposed method used an iterative algorithm, which decomposed the ultrasound Doppler signals into linear expansion of atoms in a time-frequency dictionary by using the Matching Pursuit (MP) for de-noising the ultrasound Doppler signal. Subsequently, a simplified unidirectional pulse coupled neural network was applied to calculate the firing matrix of the denoised spectrogram. The Doppler speckles were located and removed through analyzing and processing the PCNN firing matrix. Experiments were conducted on simulation signals which SNRs were 0dB, 5dB and 10dB. The result showed that the MP-PCNN performed effectively in reducing noise, eliminating Doppler speckles, and achieved better performance than exiting noise and speckle suppression algorithm for Doppler ultrasound blood flow spectrogram.

place of transvaginal color and pulsed Doppler sonography in the diagnosis of benign and malignant endometrial pathology in patients with post menopausal bleeding

Transvaginal color Doppler ultrasound [TVCDUS] may play significant role in diagnosis of endometrial pathology particulary endometrial carcinoma in women with postmenopausal bleeding [PMB]. Increasing experience in this field may help many women to overcome long waiting lists for surgery. In [65] women with postmenopausal bleeding we measured endometrial thickness [ET] [double layer] considering [8] mm as cut-off point to differentiate between benign and malignant endometrial lesions. We also looked for homogenicity, regularity of endometrium and integrity of sub endometrialhalo. [TVCDUS] was used to asses the vascularity, and vascular density of endometrium, myometrium and endometrial tumor. Resistance index [RI] and peak systolic velocity [PS] were also measured for endometrial, myometrial and uterine arteries. Correlation between [TVCDUS] and results of histopathology of endometrial specimens [24 hysterectomy and 41 D and C] was done. [ET] of [8] mm was found to be predictive for endometrial carcinoma with sensitivity of 100% and visualization rate of endometrial flow was significantly higher in case of carcinoma versus benign conditions of endometrium. Vascular density was significantly higher in case of carcinoma. [RI] of [0.42] was considered as cut-off point to differentiate between benign and malignant lesions with sensitivity of [80%]. [PI/ ] for myometrial and uterine arteries were not significantly different between cancer and benign conditions. TVCDUS has an important role in diagnosis of endometrial carcinoma especially in high risk group of women. Intra-tumoral blood flow is more sensitive marker of carcinoma than uterine blood flow. Adopting this method with increasing experience may result with considerable saving of both potential and economic costs

Estudio integral no invasivo de la estructura y función arterial: discusión de aspectos teóricos y prácticos del abordaje implementado en CUiiDARTE (centro universitario de investigación, innovación y diagnóstico arterial): [revisión] / Non-invasive integral study of arterial structure and function: discussion of theoretical and practical features of the approach implemented at CUiiDARTE (centro universitario de investigación, innovación y diagnóstico arterial): [review]

Los sistemas de prevención cardiovascular basados en la determinación de factores de riesgo presentan limitaciones para cuantificar el riesgo de un sujeto. Los factores de riesgo son predictores de aterosclerosis en la población, pero fallan en identificar qué sujetos desarrollarán la enfermedad y/o tendrán eventos cardiovasculares; los que frecuentemente se presentan en sujetos de riesgo bajo o intermedio. En este contexto, guías/consensos sugieren realizar estudios no invasivos en sujetos asintomáticos para estratificar el riesgo individual, detectar y tratar la aterosclerosis en etapa subclínica. Para ello se han propuesto diferentes abordajes que permiten caracterizar la estructura y/o función arterial por métodos no invasivos, brindando información complementaria, que adiciona a la obtenida con la determinación de los factores de riesgo. En Uruguay, recientemente se creó un centro universitario interdisciplinario (CUiiDARTE, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial), que tiene entre sus objetivos implementar técnicas no invasivas para la evaluación integral de la estructura y función arterial, posibilitando dar respuesta a la necesidad de estratificación individualizada del riesgo cardiovascular y detección de aterosclerosis subclínica. En este trabajo se presenta el abordaje de evaluación vascular empleado en CUiiDARTE y basados en nuestra experiencia, se discuten aspectos teóricos y prácticos de los test no invasivos utilizados y parámetros estudiados.

Traditional risk factors-guided cardiovascular prevention/treatment has clear limitations in individual subjects management. Often, individuals with similar risk factor profiles have differences in the atherosclerosis development and are at different cardiovascular risk. Therefore, while risk factors are good predictors of atherosclerosis in a population, they cannot identify who will develop the disease and/or will have a cardiovascular event. In this context, there have been published guidelines calling for non-invasive atherosclerosis screening and risk stratification in asymptomatic subjects. Several approaches have been proposed for the vascular evaluation, and although the screening tests used vary among laboratories, in general terms their are underused. In Uruguay, it was recently created an interdisciplinary university center (CUiiDARTE, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial), which has as a main aim the implementation of non-invasive techniques to evaluate the arterial structural and functional properties, that could allow stratifying the individual cardiovascular risk and identifying sub-clinical atherosclerosis. In this work we present the integral vascular approach used in CUiiDARTE and based in our experience we discuss, theoretical and practical issues related with the tests performed and parameters calculated.

Effect of carvedilol on portal pressure estimated by hepatic vein doppler ultrasound waveform and damping index in cirrhotic patients

To assess the effect of Carvedilol in reducing portal pressure estimated non-invasively by studying Doppler ultrasound waveforms [DUS] and hepatic vein Damping Index [DI]. Quasi-experimental study. Department of Medical ICU in collaboration with Department of Radiology, JPMC, over a period of 6 months [June 1st to 30th November, 2008]. Of the enrolled 65 patients, 47 patients [33 males and 14 females] completed the study. The mean age was 47.4 years. Cirrhotic patients of Hepatitis B, C, D [delta], B and C combined, B and D combined with varying degrees of portal hypertension were included in the study. Cirrhotic patients with bronchial asthma, congestive heart failure, Insulin dependent Diabetes, portal vein thrombosis and hepatorenal syndrome were excluded from the study. The patients were examined by color flow Doppler of the right hepatic vein before and after administration of Carvedilol. Their waveforms and Damping Index [Dl] were recorded and compared by Wilcoxon signed ranks test through SPSS version 12.0. Responders were described as those showing a positive change in wave forms or a decrese of 0.10 or more in Dl. Of the 47 patients, 30 [63%] showed a positive response and 10 [21%] showed no favorable response to Carvedilol, while 7 [14%] patients showed deterioration. The mean Dl on DUS dropped from 0.62 to 0.41 in responders after treatment, while in the non-responders it ranged between 0.42 and 0.57. Ultrasonography Carvedilol reduced portal pressure of cirrhotic patients, as measured indirectly by the damping index of hepatic waveform by Doppler

A utilização terapêutica com ultra-som contínuo de 1 MHz nos processos dolorosos da artrite reumatóide da articulação temporomandibular / The use of therapeutic ultrasound in a continuous uninterrupted mode of 1 MHz on pain procedures of rheumatoid arthritis in temporomandibular joint

Este estudo está baseado no uso do ultra-som de 1 MHz do tipo pulso contínuo nas intervenções dolorosas da artrite reumatóide da articulação temporomandibular e a aplicação de uma escala analógica de intensidade da dor antes e após o tratamento. O objetivo deste trabalho foi avaliar os efeitos da terapia ultra-sônica no processo de melhora da escala de dor referida pelos pacientes. Este trabalho foi realizado no Laboratório LABINFLA (Laboratório de inflamação, dor e laser) do Centro Universitário de Caratinga – UNEC - Minas Gerais com aplicação do ultra-som de 1 MHz em 15 pacientes na faixa etária de 65 e 80 anos, sendo 14 mulheres e 1 homem. Foi utilizado um ultra-som modelo Bioset, com tempo de aplicação de 2 minutos na articulação temporomandibular direita e 2 minutos na articulação temporomandibular esquerda. Todos os pacientes apresentaram melhora no processo doloroso após a aplicação do ultra-som. Os resultados obtidos com estes pacientes sugerem que a terapia com ultra-som seja capaz de promover a melhora do quadro de dor nestes pacientes. Sugere-se que os próximos estudos tenham um maior n. e sejam controlados de forma randomizada para garantir ainda mais fidedignidade para o estudo proposto.

This study is based on the use of a pulsed and continuous ultrasound of 1 MHz in pain interventions of rheumatoid arthritis of temporomandibular joint and implementation of a visual analogue pain intensity scale before and after treatment. The objective of this study was to evaluate the effects of ultrasonic therapy to improve pain scale process reported by patients. This work was conducted at the Laboratory LABINFLA (Laboratory of inflammation, pain and laser) of Centro Universitário de Caratinga - UNEC - Minas Gerais. 15 patients, aged group 65-80 years, 14 women and 1 man, were assigned to receive ultrasound of 1 MHz. It was used an ultrasound Bioset model of 2 minutes of exposure in the right temporomandibular joint and 2 minutes in the left temporomandibular joint. All patients showed improvement in the painful process after receiving ultrasound. The results suggest that ultrasound therapy is able to promote improvement in pain process of these patients. It is suggested that next studies should have a larger sample of patients, controlled and randomized to ensure more reliability to the proposed study.