Power Doppler ultrasound imaging for quantification of urinary bladder neck blood flow changes

This study was designed to evaluate power Doppler imaging for assessment of urinary bladder neck blood flow in comparison with laser Doppler flowmetry (LDF) in an animal model. Transrectal power Doppler ultrasound (US) and LDF of the urinary bladder neck were performed in three anesthetized pigs during comparative cystometry. Normal saline (NaCl) was used for the first run, followed by a second run with 0.2 mol/L potassium chloride (KCl). Standardized sonographic equipment settings (Acuson Sequoia 512); MountainView, CA) were used for power Doppler imaging. Computer-assisted calculation of color pixel density (CPD) of power Doppler images was performed using Scion Image) software image analysis. Tissue perfusion units (TPU) were measured using a BLF21 laser Doppler flowmeter (Transonic Systems Inc., Ithaca, NY, USA). The power Doppler results were compared with the findings obtained by LDF. NaCl filling resulted in a mean CPD increase at the bladder neck from 18.65 (+/- 1.78) at empty bladder to 37.8 (+/- 1.84) at 100 mL and to 88.32 (+/- 1.35) at full bladder capacity (C(max)) of 270 mL, respectively. With KCl filling, a mean CPD increase from 18.65 (+/- 1.78) to 59.63 (+/- 0.5) at 100 mL and 110.82 (+/- 2.98) at full bladder capacity (270 mL) was observed. The CPD increase was significantly higher for KCl than with NaCl (p < 0.001). With NaCl filling, bladder neck blood flow increased from 22 TPU (empty) to 46 TPU (100 mL) and 62.5 TPU at C(max), compared to 22 TPU, 50 TPU and 102.5 TPU with KCl. CPD and TPU measurements showed a strong correlation at p = 0.01. In conclusion, transrectal power Doppler US image quantification is a feasible and accurate method for assessing blood flow changes in the urinary bladder neck.     

Prenatal diagnosis of placenta previa accreta by transabdominal color Doppler ultrasound.

OBJECTIVE: The aim of this study was to evaluate the efficacy of transabdominal color Doppler ultrasound in diagnosing placenta previa accreta. DESIGN: Eighty patients with persistent placenta previa underwent transabdominal B-mode and color Doppler ultrasound evaluation in the second and third trimesters because they had a high risk of placenta accreta. Color Doppler imaging criteria used included diffuse intraparenchymal placental lacunar flow; focal intraparenchymal placental lacunar flow; bladder-uterine serosa interphase hypervascularity; prominent subplacental venous complex; and loss of subplacental Doppler vascular signals. The color Doppler images were interpreted prospectively for signs of placenta previa accreta according to the exhibited color Doppler sonographic features. RESULTS: Sixteen of the 80 patients exhibited characteristic color Doppler imaging patterns highly specific for placenta accreta according to the preceding criteria, and 14 of these had histopathological proof of placenta accreta. Two patients had false-positive color Doppler imaging evidence mistaken for interphase hypervascularity caused by bladder varices. Thirteen patients underwent hysterectomy in the group suspicious for accreta. Of the 64 patients with negative color Doppler imaging results, three had placenta accreta, while two required cesarean hysterectomy; the remaining patient underwent uterine artery ligation for bleeding from the lower uterine segment. The sensitivity of color Doppler imaging in the diagnosis of placenta previa accreta was 82.4% (14/17) and the specificity was 96.8% (61/63). The positive and negative predictive values were 87.5% (14/16) and 95.3% (61/64), respectively. CONCLUSIONS: Variable vascular morphological patterns of placenta previa accreta were exhibited and categorized by transabdominal color Doppler sonography in the antenatal period. The identification of these specific vascular patterns had a positive impact on the peripartum clinical management of the affected patients.     

膀胱恶性肿瘤的超声及病理对照

目的 探讨膀胱肿瘤的超声显像、血流分级及与病理分级的关系.方法 分析35例经手术病理证实的膀胱肿瘤声像图特点,与病理结果对比.结果 膀胱肿瘤内血流特征为高速、较高阻力,显示率为81.4%(35/43);膀胱肿瘤大小和超声分期、血流分级、病理分级之间有统计学相关性(P＜0.05);肿瘤内血流速度、PI、RI与肿瘤大小、分期和病理分级无统计学意义.结论 超声检查对膀胱肿瘤的诊断与分期有一定的临床价值.     

经直肠彩超在诊断前列腺肉瘤中的价值

目的：探讨经直肠超声检查前列腺肉瘤的图像特点和内部血流变化。方法：在适当膀胱盈情况下经直肠探查前列腺,观察肿瘤大小,形态,内部回声,突入膀胱腔的程度,彩超探测肿瘤内的血流分布,速度,阻力指数。结果：7例前列腺肉瘤超声显示前列腺呈球形混合性肿块,表面不规则,呈菜花状向膀胱腔突出,肿瘤内血 供应丰富,平均血流速度为34cm/s,阻力指数（RI）平均为0．78。结论：经直肠彩超诊断前列腺肉瘤可靠性强,能显示整个肿瘤大小,内部回声,浸润程度,血流供应情况,有利于手术方法选择。     

彩色多普勒超声在凶险性前置胎盘合并胎盘植入中的应用价值

目的研究彩色多普勒超声在凶险性前置胎盘合并胎盘植入中的应用价值。方法选取2017年6月至2018年6月我院收治的200例孕妇为研究对象,以手术病理诊断结果为金标准,分析彩色多普勒超声诊断凶险性前置胎盘合并胎盘植入的临床诊断特征及诊断效能(灵敏度、特异度、误诊率和漏诊率)。结果凶险性前置胎盘合并胎盘植入患者经彩色多普勒超声诊断的突出影像学特征为子宫肌层弓状动脉排列和子宫浆膜层与膀胱交界处血管呈现紊乱,宫颈管胎盘覆盖处血流丰富并有异常的血流进入子宫肌层。彩色多普勒超声诊断凶险性前置胎盘合并胎盘植入的灵敏度为92.50%(37/40),特异度为99.38%(159/160),误诊率为0.63%(1/160),漏诊率为7.50%(3/40)。结论彩色多普勒超声诊断凶险性前置胎盘合并胎盘植入的价值显著,可作为凶险性前置胎盘合并胎盘植入患者首选的检查方案,值得临床推广应用。     

正常移植肾血流的三维彩色多普勒成像特征

目的探讨正常移植肾血流的三维彩色多普勒成像特征。方法功能正常的同种异体移植肾患者22例；仪器为Acuson X／P 128彩色多普勒超声诊断仪(探头频率3.5MHz)和Tom Tec Echoscan 4．2三维彩色多普勒图像处理工作站，采用磁场空间定位自由扫查系统进行三维图像获取，脱机后进行移植肾血流的三维图像重建与显示。结果移植肾血流的三维彩色多普勒图像特征为，可以立体地显示整个肾脏的血管树结构及血管变异特征。结论三维彩色多普勒超声成像技术能够对肾脏血管进行完整、直观、立体地显示，是对二维超声切面成像的一个有意义的改进和提高。     

Hormonal replacement therapy and urinary problems as evaluated by ultrasound and color Doppler.

OBJECTIVE: To determine how hormone replacement therapy modifies bladder vascularization and urinary symptoms. STUDY DESIGN: Twenty-eight postmenopausal women with urinary symptoms (day-time frequency > 8; nocturia > 1; urgency and/or dysuria) were analyzed before and after 1, 3 and 6 months of hormone replacement therapy. The patients underwent transvaginal ultrasound evaluation of the pelvic organs and endometrial and bladder wall thickness. Transvaginal color Doppler analysis of blood flow impedance of the uterine and intramural bladder wall arteries was performed in all cases. RESULTS: Hormone replacement therapy significantly increased bladder wall and endometrial thickness. This result was associated with significant improvements in uterine and bladder wall vascularization. Urinary symptoms also improved during therapy. CONCLUSION: The study of bladder wall thickness and vascularization provides additional information regarding the beneficial effect of hormone replacement therapy on lower urinary tract symptoms in postmenopausal women.     

超声检查在腺性膀胱炎诊断中的应用

目的探讨超声检查在腺性膀胱炎诊断中的临床价值。方法使用彩色超声诊断仪观察腺性膀胱炎患者膀胱壁及其周围情况,尤其要清晰显示膀胱三角区及膀胱颈部,总结其声像图特点。结果本组28例腺性膀胱炎经超声确诊24例,误诊为膀胱肿瘤4例,符合率85．7l％。结论超声检查方便、经济、对人体无伤害,可重复检查,并能直观显示膀胱内病灶的大小、部位、形态及病变处膀胱各层受侵犯程度,可作为腺性膀胱炎诊断的首选方法。     

利声显对肝肿瘤血流信号和肝实质区回声增强作用的研究

目的:评价新型利声显对不同肝肿瘤的彩色多普勒信号和肝实质区回声的增强作用。材料和方法:肝肿瘤患者共44例,其中原发性肝癌35例、继发性肝癌5例、肝血管瘤3例、肝硬化结节1例。使用HP Sonos 2500型彩超仪,控头频率2.5MHz。将利声显稀释为浓度为300mg/ml的溶液,由外周静脉注入,持续观察肿瘤彩色多普勒信号增强程度及肝脏实质区回声。结果:彩色多普勒信号增强情况为:32例原发性肝癌和1例较大胆囊转移癌明显增强,3例原发性小结节型肝癌、4例转移性结节性肝癌、2例肝血管瘤轻度增强,肝硬化结节无增强。肝实质区图像清晰度改善,于4例原发性肝癌患者的肝区内又测及新的小病灶。结论:利声显可增强肝肿瘤的血流信号,且不同肝肿瘤的增强程度有差异。它对判断肿瘤的血供情况、初步分析肿瘤的病理性质,提高超声诊断的敏感性很有益处。     

经直肠超声对表面完全钙化的膀胱癌和膀胱嵌壁结石的鉴别诊断

目的 探讨经直肠超声在鉴别诊断位于膀胱三角区表面完全钙化的膀胱癌和膀胱嵌壁结石的价值.方法 对 47例病灶位于膀胱三角区的患者行经腹及经直肠超声检查,观察病灶活动度,对比分析两种检查途径的二维声像图、彩色多普勒血流成像（CDFI）及膀胱壁情况.结果 经腹超声检查膀胱癌和膀胱嵌壁结石均表现为膀胱腔内不移动强回声后伴声影.经直肠超声可清楚显示膀胱癌低回声肿块和表面强回声,该处膀胱壁层次不清,CDFI可见迂曲树枝状彩色血流信号自膀胱壁进入低回声内,可测及动脉血流频谱.膀胱嵌壁结石经直肠超声检查表现为强回声后伴声影,膀胱壁层次尚清楚,CDFI未探及彩色血流信号.膀胱癌经腹与经直肠超声检查结果比较差异有统计学意义（χ2＝56,P＜0.01）,嵌壁膀胱结石经腹与经直肠超声检查结果比较差异无统计学意义（P＞0.05）.结论 经直肠超声在鉴别诊断位于膀胱三角区表面完全钙化的膀胱癌和膀胱嵌壁结石中有重要价值.     

经直肠彩色多普勒超声膀胱肿瘤显像的临床价值

目的　探讨经直肠腔内彩色多普勒超声显像对膀胱肿瘤的临床价值。方法　对 3 6例膀胱肿瘤患者先经腹壁再经直肠进行彩色多普勒超声检查 ,对两种方法的显示率进行比较 ,记录血流参数 ,进行统计学分析。结果　经腹壁和经直肠彩色多普勒显像肿瘤显示率分别为 61%和 97% ,有显著差异 (P <0 .0 5 )。最大血流速度Vmax和最小血流速度Vmin在较小的肿瘤低 ,较大肿瘤高。阻力指数RI在较小的肿瘤高 ,较大肿瘤低 ,但没有统计学差异 (P >0 .0 5 )。结论　膀胱肿瘤彩色多普勒超声显像经直肠检查方法优于经腹壁方法 ,特别是小于 2 .0cm的膀胱肿瘤     

乳腺癌二维超声、彩色多普勒血流显像、剪切波弹性成像、造影参数联合评估与病理对照

目的  分析乳腺癌超声多参数(二维高频超声、彩色多普勒血流显像、剪切波弹性成像、造影)评估与病理对照。方法  选择2018年4月~2020年9月我院诊治的乳腺占位性病变患者61例(72个病灶),均行二维高频超声、彩色多普勒血流显像、剪切波弹性成像、造影和病理检查,以术后病理检查结果为金标准。计算各种检查方法诊断乳腺癌的敏感度、准确度。结果  术后病理诊断结果示：61例(72个病灶)中有43例恶性(51个病灶),18例良性(21个病灶);二维高频超声诊断乳腺癌敏感度47.06%,特异性66.67%,准确度52.78%;彩色多普勒血流显像敏感度60.78%,特异性71.43%,准确度63.89%;剪切波弹性成像敏感度82.35%,特异性80.95%,准确度81.94%;超声造影敏感度86.27%,特异性85.71%,准确度86.11%;联合诊断敏感度94.12%,特异性90.48%,准确度93.06%。联合诊断乳腺癌准确率高于单独二维、彩色多普勒血流显像、剪切波弹性成像、造影检查(P < 0.05)。结论  乳腺癌超声多参数(二维、彩色多普勒血流显像、剪切波弹性成像、造影)联合检查,可明显提高乳腺癌诊断的准确率。     

利声显对肝、肾、子宫肿瘤血流信号增强作用的研究

目的　评价利声显对肝、肾、子宫肿瘤彩色多普勒信号的增强作用。方法　对３５ 例原发性肝癌、５ 例继发性肝癌、３ 例肝血管瘤、１ 例肝硬化结节、３ 例肾癌、３ 例子宫肌瘤进行研究。将７ ｍｌ 浓度为３００ ｍｇ／ｍｌ 的利声显由外周静脉注入,观察肿瘤彩色多普勒信号增强程度及脏器实质区图像。结果　３２ 例原发性肝癌和１ 例较大的胆囊转移性肝癌的彩色多普勒信号明显增强,肝血管瘤的略增强,肝硬化结节的无增强,肾癌和子宫肌瘤的增强均好,且实质区图像改善,于４ 例原发性肝癌患者的肝区内又探及新的小病灶。结论　利声显对肝、肾、子宫肿瘤的血流信号均有增强作用,它对判断肿瘤的血供情况、分析肿瘤的病理性质,提高超声诊断的敏感性很有益处。     

Evaluation of breast tumors with color Doppler imaging: A comparison with image-directed Doppler ultrasound

Doppler ultrasound is an adjunct to other imaging modalities in differentiating benign from malignant breast tumors. Two groups of patients with breast nodules were examined using a 10/4.5 MHz (imaging frequency/pulsed Doppler frequency) image-directed Doppler probe and a 7.0/5.0 MHz color Doppler imaging probe, separately. Whenever flow signals were detected within or at the margin of the breast nodule, the lesion was considered to be malignant. In detecting malignant breast tumors, the sensitivity was 77.3% and 94.5%, specificity 83.3% and 40.1%, accuracy 81% and 63.4% for image directed Doppler and color Doppler imaging, respectively. We found color Doppler to be easier and more efficient in detecting the flow signals of neovascularity in breast tumor. Color Doppler exhibits a higher sensitivity in detecting the malignant breast tumors. However, more false-positive diagnoses were made. Color Doppler ultrasound also expedited the examination, and the whole procedure could be shortened from 35 minutes to 8 minutes compared with our previous examination performed by image-directed Doppler ultrasound. Due to its higher sensitivity and saving in examination time, we use color Doppler imaging as a routine procedure when solid lesions are observed in x-ray mammography or sonography, as a supplement to the diagnosis of breast tumors. © 1995 John Wiley & Sons, Inc.     

高强度体外聚焦超声热疗治疗盆腹部转移癌疗效的超声观察

目的：评价高强度体外聚焦超声热疗（HIFU）治疗盆腹部转移癌的临床应用价值及彩色多普勒超声治疗前后声像图变化。方法：15例转移癌共21个癌瘤HIFU治疗前后均进行彩超检测。观察其大小，内部回声及血供改变情况。并观察HIFU治疗后癌瘤病理组织学改变。结果：治疗有效率76%（16/21），治疗后彩超表现为癌瘤缩小，回声增强，血供明显减少或消失，病理组织学上表现为凝固性坏死或纤维化形成。结论：HIFU对盆腹部转移癌治疗有效。彩超能直观反映其疗效。     

Evaluation of ureterocele with Doppler sonography

Ureterocele is a common disorder characterized by cystic dilatation of the terminal submucosal portion of 1 or both ureters. Conventional imaging modalities for the diagnosis of ureterocele include intravenous urography and voiding cystourethrography; gray-scale sonography, augmented by color Doppler and spectral analysis studies, can be useful in diagnosing and managing this condition as well. We describe the diagnosis of ureterocele using transvaginal gray-scale and color Doppler sonography with spectral analysis in 2 women. Color Doppler sonography demonstrated urine flow into the bladder, and spectral analysis was used to measure the flow velocity. Together, these modalities can provide additional information about urinary flow dynamics, aid in implementing treatment for patients with ureterocele, and eliminate the need for invasive diagnostic procedures.     

Myocardial motion imaging: a new application of power color flow and frequency-based color flow Doppler in fetal echocardiography.

OBJECTIVE: Myocardial motion imaging is a new way of looking at the fetal heart using power color flow and frequency-based color flow Doppler to demonstrate heart wall movement in color. This study set out to assess the value of myocardial motion imaging in fetal echocardiography in a routine clinical setting. DESIGN: In our hospital, all patients at high risk of carrying a fetus with a cardiac abnormality are offered detailed ultrasound scanning, including fetal echocardiography, at 20 weeks' gestation. A prospective study was carried out over a 2-month period and, in addition to conventional fetal echocardiography, myocardial motion imaging was also carried out on all patients, by means of both power color flow and frequency-based color flow Doppler ultrasound. RESULTS: Myocardial motion imaging demonstrated fetal heart wall movement in 26 of the 27 patients. Myocardial motion imaging using power color flow gave a global view of fetal heart wall movement, demonstrating both atrial and ventricular contraction simultaneously. Myocardial motion imaging using frequency-based color flow Doppler demonstrated atrial and ventricular contractions separately. In addition, as the direction of fetal heart wall motion can be color coded, atrial contractions, ventricular relaxation and ventricular contraction were demonstrated, providing a functional assessment of fetal heart wall movement. Two cases of cardiac abnormality were also studied, one case of hypoplastic left heart syndrome and one case of atrioventricular septal defect. In both cases functional information was obtained using myocardial motion imaging, and the technique also highlighted the anatomical defect. CONCLUSIONS: Myocardial motion imaging produces both a global view of fetal cardiac anatomy and a functional assessment of individual chamber contraction in the normal and abnormal heart. It may prove to be a useful adjunct to conventional color flow Doppler assessment of the fetal heart.     

Correlation between prostate cancer grade and vascularity on color doppler imaging: preliminary findings

PURPOSE: We examined the relationship between the amount of prostate cancer-associated vascularity as seen on color Doppler imaging and the tumor grade. METHODS: Transrectal color Doppler imaging of the prostate was performed in 54 patients with prostate cancer. Color flow signal/total pixel ratios (SPRs) of selected images were calculated using the ratio of the number of pixels showing color Doppler signals to the total number of pixels within the lesion. All the patients underwent prostate biopsy guided by transrectal sonography. Gleason scores were determined from the biopsy specimens. RESULTS: Color Doppler signals were demonstrated in the lesions of 91% (49/54) of the patients. The mean SPRs of prostate cancers 3 cm or smaller and larger than 3 cm were 0.15 +/- 0.07 and 0.11 +/- 0.04 (+/- standard deviation), respectively (p < 0.05). The mean SPRs of well- (Gleason score of 2-4), moderately (Gleason 5-7), and poorly (Gleason 8-10) differentiated prostate cancers were 0.08 +/- 0.03, 0.12 +/- 0.06, and 0.17 +/- 0.11, respectively (r = 0.45; p < 0.01). CONCLUSIONS: The refinement of color Doppler equipment has improved the detection of color Doppler signals associated with prostate cancer. Our study shows a correlation between prostate cancer-associated vascularity as shown on color Doppler imaging and the tumor grade.     

彩色多普勒超声在不同类型布-加综合征诊断与治疗中的价值

目的探讨彩色多普勒超声在不同类型布-加综合征(BCS)诊断与治疗中的价值。方法应用彩色多普勒超声对临床拟诊的不同类型BCS患者106例及30例健康对照者进行检测,观察其特异性血管形态及血流动力学变化,与DSA对比,并治疗后随访。结果(1)超声诊断BCS90例,DSA确诊89例,超声诊断的敏感性97.8%,特异性82.4%,准确性95.3%,假阳性率17.7%,假阴性率2.3%。(2)血流动力学变化:与对照组相比,下腔静脉(IVC)狭窄者可见局部高速血流,阻塞者局部无血流信号;肝静脉(HV)扩张,血流减慢,并可见肝内侧枝血管;门静脉(PV)入肝血流速度减慢.(3)介入治疗及手术后随访:①介入治疗后,IVC病变处增宽,血流恢复,并可见支架回声,HV及PV血流速度加快;②手术治疗组,根治者可见IVC及HV血流恢复正常,人工血管转流者,可见人工血管呈螺旋管状,内血流清晰。结论彩色多普勒超声对BCS的诊断与血管造影具有良好的相关性,可明确BCS特异性异常血管形态及血流动力学变化,是BCS诊断及术后随访的可靠方法。     

Application of Doppler color flow imaging method on the detection of vesicoureteral reflux

The doppler color flow imaging method was employed to detect the vesicoureteral reflux. The ultrasound examination was performed by using the doppler color flow imaging system. Ultrasonic sector scan was carried out by the use of the 3.75 MHz phased array and/or conbex array transducer with a transabdominal approach. The flow in the bladder from the ureteral orifice to the bladder was detected with a red color indicating the direction towards the probe and the flow from the bladder towards the ureteral orifice during the vesicoureteral reflux was detected with a blue color indicating the direction away from the probe. The doppler color flow imaging method appears to be a useful diagnostic procedure for the detection of the vesicoureteral reflux.