Fine‐tuning the Diagnosis of Fetal Scalp Cysts

Objective. The purpose of this series is to emphasize the importance of an exhaustive and appropriately conducted sonographic examination in the correct diagnosis of fetal cystic scalp lesions and the place of magnetic resonance imaging (MRI) in the diagnostic sequence. Methods. Transabdominal and transvaginal 2‐ and 3‐dimensional sonography with color and power Doppler imaging as well as 3‐dimensional rendering techniques such as inversion and Doppler angiography were used. In 1 case, an MRI study was performed. Results. In 1 case, the MRI missed and the different sonographic techniques correctly made the diagnosis of a meningocele. In the second case, sonography was sufficient to establish the diagnosis of an epidermal cyst. Conclusions. These 2 cases show the value of going the distance with the newly available high‐frequency sonography. Ultimately, the correct diagnoses were made with the tools offered by sonography without the need for any other imaging modality.     

Correlation Between Doppler Parameters and Renal Cortical Fibrosis in Lupus Nephritis: A Preliminary Observation

To assess the relationship between renal Doppler parameters and renal cortical fibrosis in lupus nephritis (LN), we retrospectively reviewed 24 patients with LN underwent both renal color Doppler sonography and renal biopsy. The angle-corrected Doppler parameters, including peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) at the main and interlobar renal arteries were measured. The Doppler parameters and PSV and EDV ratios of the interlobar artery to main renal artery were compared with histopathologic analysis of the kidney biopsy specimen. On the basis of renal cortical fibrosis, the 24 cases of LN were divided into two groups: mild (6%–25%) renal cortex fibrosis (n = 13) and moderate (26%–50%) renal cortex fibrosis (n = 11). An independent-samples two tailed t test was used to statistically analyze the differences in PSV, EDV and RI between the two groups. Receiver operating characteristic was analyzed for assessing the accuracy of interlobar artery PSV and EDV in predicting moderate renal cortical fibrosis. In our result, both PSV and EDV in moderate renal cortex fibrosis were lower than that in mild renal cortex fibrosis. There were statistically significant differences in PSV and EDV at the interlobar artery, EDV and RI at the main renal artery, and PSV and EDV ratios of the interlobar artery to main renal artery between the two groups (all p < 0.05). The area under receiver operating characteristic curves of PSV and EDV for predicting >26% renal cortical fibrosis was 0.96 and 0.90, respectively. The optimal cutoff values for differentiating >26% renal cortical fibrosis from those <25% were PSV 30 cm/s (sensitivity = 0.92; specificity = 1) and EDV 13 cm/s (sensitivity = 0.77; specificity = 1). Therefore, the values of PSV and EDV at the interlobar artery can potentially be used as hemodynamic indicators of renal cortical fibrosis, which may non-invasively assist in monitoring the progression of renal cortical fibrosis in LN, especially in patients with contraindications to renal biopsy.     

Sonographic Appearance of Trigger Fingers

Objective. The purpose of this study was to describe the sonographic appearance of the first annular (A1) pulley–flexor tendon complex in patients with trigger fingers. Methods. Thirty‐three trigger fingers in 33 patients were examined with a 7‐ to 15‐MHz probe. A control group consisted of 20 patients without trigger fingers. The study included systematic measurement of the thickness of the A1 pulley and a power Doppler assessment of the pulleys, tendons, and tendon sheaths. Results. Thickening and hypoechogenicity of the A1 pulley were found in all patients with trigger fingers. Measurements of A1 pulley thickness were significantly different (P < .0001) between the groups without trigger fingers (mean, 0.5 mm; range, 0.4–0.6 mm) and with trigger fingers (mean, 1.8 mm; range, 1.1–2.9 mm). Hypervascularization of the A1 pulley on power Doppler imaging was found in 91% of the trigger fingers but was never found in the healthy control group. Flexor tendinosis was found in 48% of the trigger fingers; tenosynovitis was found in 55%; and both were found in 39%. In the control group, tenosynovitis and tendinosis were not found. Conclusions. Thickening and hyper‐vascularization of the A1 pulley are the hallmarks of trigger fingers on sonography. Other frequently observed features include distal flexor tendinosis and tenosynovitis.     

Doppler Sonographic Criteria for the Diagnosis of Inferior Mesenteric Artery Stenosis

Objective. The purpose of this study was to define the optimal Doppler criteria for the diagnosis of inferior mesenteric artery (IMA) stenosis in patients with suspected chronic mesenteric ischemia (CMI). Methods. A retrospective review of 205 dedicated color and pulsed Doppler sonographic studies of mesenteric arteries was performed in 205 patients. All studies were performed in patients with suspected CMI. Correlative angiography was available in 50 patients. Results. The IMA was visualized in 176 of 205 Doppler sonographic examinations (86%) and in 92% of the correlative studies. The visualization rate for the detection of a patent IMA by Doppler sonography in this series was 90%. The ranges of the peak systolic velocity (PSV), end‐diastolic velocity (EDV), and mesenteric‐aortic velocity ratio (MAR) in the nonstenotic IMA were 70 to 200 cm/s, 0 to 33 cm/s, and 0.7 to 3.7, respectively. The ranges of the PSV, EDV, and MAR in IMA stenosis were 200 to 485 cm/s, 0 to 177 cm/s, and 0.69 to 8.1. The threshold values for severe IMA stenosis by logistic regression analysis (n = 42) were as follows: PSV, greater than 200 cm/s; EDV, greater than 25 cm/s; and MAR, greater than 2.5, with sensitivities of 90%, 40%, and 80%; specificities of 97%, 91%, and 88%; positive predictive values (PPVs) of 90%, 57%, and 67%; negative predictive values (NPVs) of 97%, 83%, and 93%; and accuracy of 95%, 79%, and 86%, respectively. Conclusions. We found that a PSV of greater than 200 cm/s was the best criterion for the diagnosis of IMA stenosis. The sensitivity, specificity, PPV, NPV, and accuracy for the PSV were 90%, 97%, 90%, 97%, and 95%, respectively.     

Role of Sonography for Implantation and Sequential Evaluation of a VX2 Rabbit Liver Tumor Model

Objective. We investigated the role of sonography in the implantation process of a VX2 rabbit liver tumor model and sequential evaluation. Methods. Fifty rabbits were divided into 2 groups. Animals in group I underwent surgical implantation, whereas those in group II received percutaneous sonographically guided implantation. At 7, 14, 21, and 28 days after implantation, respectively, 5 rabbits in each group were examined with conventional, color Doppler (CD), contrast‐enhanced (CE) pulse inversion harmonic (PIH), and CE CD sonography. Pathologic examination was performed with hematoxylin‐eosin, nicotinamide adenine dinucleotide phosphate‐diaphorase, and succinic dehydrogenase stains. Results. Twenty‐one rabbits with tumors survived in group I, and 22 with tumors survived in group II. The mean duration of implantation ± SD in group II was 16.9 ± 3.4 minutes, whereas that in group I was 21.5 ± 4.1 minutes (P < .05). The tumor volume measured by conventional sonography increased from 0.28 ± 0.14 cm³ at 7 days to 16.49 ± 5.50 cm³ at 28 days in group I and from 0.31 ± 0.19 to 19.79 ± 4.70 cm³ in group II, whereas no significant difference existed between the groups. On CD, CE PIH, and CE CD sonography, most tumors were hypervascular before 14 days and after 14 days had peripheral vessels and central hypovascular areas, which were shown as necrotic areas by pathologic examination. Conclusions. Sonographically guided implantation achieved a good success rate with convenient inoculation performance. Conventional gray scale, CD, CE PIH, and CE CD sonography were useful in sequential evaluation of tumor growth and characteristic vascularity.     

Ultrasound Shear Wave Elastography and Doppler Sonography to Assess the Effect of Hydration on Human Kidneys: A Preliminary Observation

To assess the feasibility of ultrasound imaging in depicting the changes in kidney size, hemodynamics and cortex viscoelasticity after hydration, we prospectively performed 2-D ultrasound shear wave elastography (SWE) and Doppler sonography of bilateral kidneys in 30 volunteers. Kidney length, cortex shear wave velocity (SWV), shear wave dispersion (SWD), interlobar artery peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI) were measured before and 60 min after with and without drinking water (1 L). The differences in kidney length, SWV, PSV, EDV and color pixel intensity before and after hydration were significant (p < 0.001), whereas these differences were not significant without hydration (p > 0.05). SWD and RI did not significantly differ with or without hydration. Inter- and intra-observer reliability in performing SWE and Doppler sonography was good. The use of Doppler sonography and ultrasound SWE to evaluate the effect of hydration on kidney size, hemodynamics and viscoelasticity seem to be feasible.     

Blood Flow in the Internal Carotid Artery With Common Carotid Artery–Occluding Lesions in Takayasu Arteritis

Objective. The purpose of this study was to investigate carotid artery hemodynamics and blood flow involving external carotid artery (ECA) and internal carotid artery (ICA) patency in patients with Takayasu arteritis (TA). Methods. The common carotid artery (CCA), ECA, ICA, and vertebral artery (VA) were examined in 19 patients with TA involving ECA and ICA patency and in 19 healthy control participants. Bilateral carotid sonographic studies were performed with the use of 5‐ to 8‐MHz linear transducers. Results. Patency of the ECA and ICA was noted in 14 bilateral, 2 right‐sided, and 3 left‐sided CCA lesions. Flow in the ECA was retrograde, whereas flow in the ICA was directed cephalad and showed a low‐frequency, damped waveform or even a veinlike waveform. The peak systolic velocity (PSV) of the ICA in the patients was significantly lower than that in the control participants (P < .001). A good correlation was observed in the PSV between the ECA and ICA (r = 0.77). The VA displayed normally directed flow, a significantly larger diameter, and a higher flow velocity (P < .001). Conclusions. Color duplex sonography can identify special features of TA with CCA‐occluding lesions and permit quantification of carotid artery flow velocities and VA diameters both efficiently and practically.     

多普勒超声监测新生儿窒息患儿肾血流动力学变化

目的 探讨多普勒超声在新生儿窒息患儿肾功能损害的早期诊断、病情监测和疗效评估等临床应用中的价值。方法 选取60例出生时间在24 h内的新生儿,根据新生儿出生后1 min Apgar评分将其分为重度窒息组（Apgar评分0~3分）、轻度窒息组（Apgar评分4~7分）和正常对照组（Apgar评分8~10分）。在新生儿出生后24 h内、第3、7、10天,运用多普勒超声技术检测各组新生儿双侧肾动脉的收缩期峰值血流速度（PSV）、舒张期末血流速度（EDV）及阻力指数（RI）。同时采样血液标本,测定血清胱抑素C（sCysC）水平。结果 与正常对照组比较,出生后24 h内轻度及重度窒息组肾动脉PSV、EDV均不同程度降低（P均<0.05）,RI不同程度升高（P均<0.05）。轻度窒息组PSV在出生后第3天已基本恢复正常,EDV、RI在出生后第10天已基本恢复正常,与正常对照组比较差异无统计学意义（P>0.05）;重度窒息组出生后第10天PSV、EDV、RI与正常对照组仍有显著差异（P均<0.05）。3组新生儿随日龄增加sCysC均呈下降趋势。轻度窒息组新生儿出生后24 h内、第3天sCysC水平较正常对照组明显升高（P均<0.05）,第7天、第10天与正常对照组比较差异无统计学意义（P均>0.05）;各日龄重度窒息组患儿sCysC水平均较正常对照组明显升高（P均<0.05）。各组新生儿PSV、EDV与sCysC呈负相关;RI与sCysC呈正相关。结论 多普勒超声检测肾动脉血流动力学参数能早期准确地反映窒息新生儿肾功能状态。     

Role of Spectral Doppler Sonography in the Evaluation of Partial Testicular Torsion

Objective. The purpose of this series was to evaluate the role of spectral Doppler and color flow Doppler sonography in the evaluation of partial testicular torsion. Methods. Eight cases of partial testicular torsion, diagnosed on the basis of abnormal spectral Doppler waveforms or abnormal color flow Doppler findings, were retrospectively pooled from 2 teaching hospitals. Results. The age group ranged from 4 to 85 years. Testicles with partial testicular torsion showed variable spectral Doppler patterns, including increased, similar, or decreased amplitude of the arterial waveform relative to the contralateral testicle. Two cases showed reversal of arterial diastolic flow, and 1 case showed diastolic flow variability within the same testicle. Decreased blood flow was observed on color flow Doppler sonography in 7 of the 8 patients. Conclusions. Variability of the Doppler waveform when compared with the contralateral testicle and reversal of diastolic blood flow are indirect clues that aid in the diagnosis of partial testicular torsion.     

Doppler Velocimetry of the Ophthalmic Artery in Normal Pregnancy

Objective. This study aimed at analyzing the correlation between ophthalmic Doppler indices and gestational age (GA) in healthy patients with singleton pregnancies. Intraobserver reproducibility and right‐to‐left eye correlation were also evaluated. Methods. Healthy pregnant women (n = 289) at 20 to 40 weeks' GA were evaluated. The resistive index (RI), pulsatility index (PI), and peak ratio (PR) were determined by 2 measurements in each eye. Comparisons were performed first between the 2 measurements in each eye and later between the right and left eyes. Spearman rank correlation was used to analyze the relationship of the RI, PI, and PR with GA. Linear regression analysis was also performed. Results. No significant differences were found between the values obtained for the first and the second measurements in each eye and those for the RI, PI, and PR in the right and left eyes. There was a significant decrease in RI and PI values with advancing GA, however (ρ = ?0.264 and ?0.1192, respectively), with low R² values for both. Thus, only a small proportion of the variations observed in the RI and PI was associated with changes in GA. No significant difference was found between the PR values with regard to GA intervals. Conclusions. Doppler velocimetry is a reproducible technique for evaluation of the RI, PI, and PR in the ophthalmic artery. Unilateral analysis of these indices can be used. Linear regression analysis indicated that other factors were associated with a decrease in the RI and PI values with advancing GA. No significant change was observed in the PR values throughout normal pregnancy.     

Advantages of 3‐Dimensional Sonography in Embryo Transfer

Objective. The purpose of this study was to investigate the advantages of 3‐dimensional (3D) sonography in embryo transfer. Methods. With the use of 2‐dimensional (2D) and 3D sonography to measure the transfer distance from the fundus (TDF), 319 patients were allocated into 4 groups according to the disparity between 2D and 3D images: group 1 showed disparity of less than 3 mm; group 2 showed disparity of 3 to 5 mm; group 3 showed disparity of 6 to 9 mm; and group 4 showed disparity of 10 mm or greater. The general characteristics and pregnancy outcomes were compared among the 4 groups. Results. For 140 patients, the TDF measured by 2D sonography was different from that measured by 3D sonography, with a positive to negative range of 3 to 13 mm. Compared with the first 3 groups, the clinical pregnancy and implantation rates were lowest in group 4 (7.7% versus 34.1%, 38.1%, and 40%; 3.6% versus 18.2%, 21.2%, and 22.2%; P < .05). Conclusions. Compared with 2D sonography, uterine cavity and catheter placement may be better achieved with 3D sonography, which would improve the embryo transfer technique.     

The power Doppler velocity index, pulsatility index, and resistive index can assist in making a differential diagnosis of primary ovarian carcinoma and Krukenberg tumors: a preliminary study.

OBJECTIVE: The aim of this study was to compare the effectiveness of transvaginal power Doppler sonography with spectral Doppler analysis as an aid in preoperatively distinguishing primary ovarian carcinoma and metastatic carcinoma to the ovary (Krukenberg tumors). METHODS: Fifty women with ovarian disease were preoperatively examined with transvaginal power Doppler sonography. Six basic parameters were measured, including intratumoral peak systolic velocity, end-diastolic velocity, time-averaged maximum velocity, pulsatility index (PI), resistive index (RI), and velocity index (VeI). Blood flow analyses were detectable in all patients. Twelve patients with metastatic carcinoma to the ovary were classified as group 1; 38 patients with primary ovarian carcinoma were classified as group 2. Comparison of intratumoral blood flow analyses between the two groups was performed. RESULTS: The PI, RI, and VeI were significantly lower in patients with metastatic carcinoma to the ovary than those with primary ovarian carcinoma (P < .05). There were no significant differences in the peak systolic velocity (P = .871), end-diastolic velocity (P = .508), and time-averaged maximum velocity (P = .850) between the two groups. CONCLUSIONS: Transvaginal power Doppler sonography with spectral Doppler analysis is an effective method in evaluating intratumoral blood flow of Krukenberg tumors. Low impedance (PI, RI, and VeI) might assist us in making differential diagnoses between primary ovarian carcinoma and Krukenberg tumors according to our preliminary results.     

High‐Frequency Sonography in the Evaluation of Psoriasis

Objective. The purpose of this study was to show the potential of the latest sonographic equipment using high‐frequency probes and a very sensitive power Doppler (PD) technique in depicting both skin and nail changes in patients affected by psoriasis. Methods. The study was conducted in 30 patients with a diagnosis of psoriasis clinically performed by an experienced dermatologist and 15 healthy participants, using a currently available sonography system equipped with a variable‐frequency transducer ranging from 6 to 18 MHz and a Doppler frequency ranging from 7 to 14 MHz. Results. The images illustrated in this presentation are representative examples of the ability of sonography to show and characterize even minimal morphostructural and blood flow changes in patients with both psoriatic plaques and onychopathy. Conclusions. This report provides pictorial evidence that high‐resolution gray scale sonography with a PD technique is a real‐time and noninvasive imaging technique that can be used as an adjunct to the clinical evaluation in assessing psoriatic disease.     

Doppler sonography of the inferior and superior mesenteric arteries in ulcerative colitis

PURPOSE: The purpose of this study was to evaluate the Doppler sonographic blood-flow parameters and spectral patterns in the inferior mesenteric artery (IMA) and superior mesenteric artery (SMA) in patients with active and inactive (remission-phase) ulcerative colitis (UC). METHODS: The IMAs and SMAs of 25 patients with active-phase UC (group 1), 19 patients with remission-phase UC (group 2), and 22 healthy, asymptomatic subjects (control group) were evaluated by duplex Doppler sonography. The 25 patients in group 1 were categorized into 2 subgroups on the basis of the extent of disease as determined by double-contrast barium enema x-ray study and colonoscopy. The first subgroup (group 1a) consisted of 11 patients with active involvement of the left colon from the rectum to the splenic flexure. The second subgroup (group 1b) consisted of 14 patients with active involvement of the entire colon. The peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (Vmean), resistance index (RI), and pulsatility index (PI) were determined from the Doppler spectral analysis. The inner diameter and cross-sectional area of the IMA and SMA were measured, and the blood-flow volume was calculated. The results were compared between the patient groups and control subjects. RESULTS: In the IMA, the mean blood-flow volume, mean PSV, mean EDV, and Vmean were significantly higher, the mean PI was significantly lower, and the mean diameter and the mean cross-sectional area were significantly larger in group 1 than in group 2 or in the control group (p < 0.001). The mean PSV and the Vmean of the IMA were significantly higher in group 1a than in group 1b (p < 0.05). The mean blood-flow parameters in the SMA were not significantly different between groups 1 and 2 or between either group 1 or group 2 and the control subjects. The mean EDV in the SMA was significantly higher and the mean PI and the mean RI were significantly lower in group 1b than in group 1a (p < 0.01). CONCLUSIONS: Duplex Doppler sonography of the IMA and SMA can be used to evaluate inflammatory disease of the large bowel, to assess disease extent, and to document response to therapy.     

Correlation of Quantified Contrast‐Enhanced Sonography With In Vivo Tumor Response

Objective.. The purpose of our study was to establish in vivo criteria for monitoring tumor treatment response using 3‐dimensional (3D) volumetric gray scale, power Doppler, and contrast‐enhanced sonography. Methods.. Twelve mice were implanted with Lewis lung carcinoma cells on their hind limbs and categorized to 4 groups: control, chemotherapy, radiation therapy, and chemoradiation. A high‐frequency ultrasound system with a 40‐MHz probe was used to image the tumors. Follow‐up contrast‐enhanced sonography was performed on days 7 and 14 of treatment with two 50‐μL boluses of a perflutren microbubble contrast agent injected into the tail vein. The following contrast‐enhanced sonographic criteria were quantified: time to peak, peak intensity, α (microvessel cross‐sectional area), and β (microbubble velocity). Three‐dimensional power Doppler images were also obtained after the acquisition of contrast data. On day 15, the tumors were excised for immunohistochemical analysis with CD31 fluorescent staining. Results.. The tumor size and 3D power Doppler vascular index showed no statistically significant correlation with microvascular density in all examined groups. Among all of the analyzed contrast‐enhanced sonographic parameters, relative α showed the strongest correlation with the histologic microvessel density (Pearson r = 0.93; P < .01) and an independent association with the histologic data in a multiple regression model (beta = .93; R² = 0.86; P < .01). Conclusions.. Of the various examined sonographic parameters, α has the strongest correlation with histologic microvessel density and may be the parameter of choice for the noninvasive monitoring of tumor angiogenic response in vivo.     

Umbilical Cord Cysts

Objective. The purpose of this series was to determine whether the use of different 3‐dimensional (3D) sonographic modes allows better definition of umbilical cord cysts and pseudocysts in utero. Methods. Two cases of umbilical cord cysts and 1 of a pseudocyst were analyzed and compared with 2‐dimensional (2D), 3D, angiopower Doppler, tomographic ultrasound imaging (TUI), virtual organ computer‐aided analysis (VOCAL), and automatic volume calculation (AVC) sonographic modes. All cases were followed during pregnancy. A karyotype analysis was also obtained. Results. Three‐dimensional sonography, TUI, and VOCAL allowed clear visualization and evaluation of the sizes, locations, and numbers of umbilical cord cysts. A clear differentiation between a pseudocyst and the yolk sac was obtained with AVC and angiopower Doppler sonography. The 3D sonographic surface mode allowed better visualization of other accompanying fetal malformations. Conclusions. Three‐dimensional sonography allows for a more accurate diagnosis and provides a clearer visualization of malformations than 2D imaging. Cysts and pseudocysts can be defined much more accurately by using the different modes described here.     

Follicular Thyroid Carcinoma With an Eggshell Calcification

Objective. The purpose of this series is to report 3 cases of follicular thyroid carcinoma with an eggshell calcification along with their imaging findings. Methods. Imaging findings on gray scale and power Doppler (PD) sonography (n = 3), computed tomography (CT; n = 3), and integrated fluorodeoxyglucose F 18 (¹⁸F‐FDG) whole‐body positron emission tomography (PET)/CT (n = 1) were assessed. Results. Of the 3 cases, two 75‐year‐old women had bone metastasis, and one 54‐year‐old woman had a thyroid incidentaloma on sonography. All 3 cases had a spherical mass with an interrupted eggshell calcification on gray scale sonography and CT; 2 revealed intranodular vascularity on PD sonography, and 1 showed intense hypermetabolism (maximum standardized uptake value, 7.9 g/mL) on integrated ¹⁸F‐FDG whole‐body PET/CT. Conclusions. Follicular carcinoma should be considered in the differential diagnosis of a thyroid nodule with an eggshell calcification.     

Radiosensitivity of Rat Mammary Tumors Correlates With Early Vessel Changes Assessed by Power Doppler Sonography

Objective . To investigate the changes occurring in the vascularization of tumors during irradiation, we used a model of autochthonous mammary tumors in rats and assessed early vascular changes after irradiation by power Doppler sonography. Methods . Mammary tumors were induced in 24 female Sprague Dawley rats by a single subcutaneous injection of N‐nitroso N‐methyl urea. After tumor areas reached 1 cm², the animals received a single fraction of 18‐Gy radiation or intraperitoneal saline injection. Power Doppler sonographic quantification of detected vessels was performed 1 day before irradiation and 7 days after the use of a power Doppler index of 5 different tumor imaging planes. Final tumor shrinkage was compared with early changes in the power Doppler index. Not all tumors regressed in a similar fashion. Radiosensitive tumors were defined as tumors with a greater than 50% decrease in baseline area 28 days after irradiation, whereas radioresistant tumors were tumors with a less than 50% decrease in baseline area. Statistical analysis was performed by the Mann‐Whitney U test. Results . Tumor area changes were similar in radioresistant and radiosensitive tumors 7 days after irradiation (–41% and –35%, respectively; P > .05, not significant), whereas reduction in the power Doppler index was significantly greater in radiosensitive tumors (mean value, –63%) than in radioresistant tumors (mean value, –12%) (P = .001). Late tumor regrowth was correlated with day 7 power Doppler index changes (P = .009). A 40% reduction in the power Doppler index at day 7 distinguished 8 of 9 radiosensitive tumors and 8 of 9 radioresistant tumors (P = .003). Conclusions . This study suggests that early changes in tumor perfusion as assessed by power Doppler sonography after tumor irradiation may precede the long‐term tumor regression.     

Anterior mediastinal lymphangioma: Pre‐ and postnatal sonographic findings

Anterior mediastinal lymphangiomas are very rare in utero with only a few cases reported in literature. We present a case of anterior mediastinal lymphangioma that was diagnosed on prenatal sonography (US) at 22 weeks' gestation. It appeared as a well‐defined, multi‐septated anechoic mass, in the anterior mediastinum between the heart base and right chest wall. There was no solid component and no internal flow on color Doppler US. The pre‐ and postnatal US findings are correlated with prenatal MRI and postnatal CT findings. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound 41 :383–385, 2013     

超声评价不同级别高血压颅内、外段血管血流动力学改变特点

目的 探讨不同级别的原发性高血压患者颈内动脉系和椎-基底动脉系颅内、外段血管血流动力学变化的特点及相关性。方法 将160例原发性高血压患者按照高血压分级分为1~3级高血压组,另选正常对照组50名。采用经颅多普勒超声及彩色多普勒血流显像分别对各组颈内动脉系颅外段的颈内动脉和颅内段的大脑中动脉、大脑前动脉,以及椎-基底动脉系的颅外段椎动脉₂和颅内段的大脑后动脉、椎动脉₁和基底动脉的收缩期峰值流速（PSV）、舒张末期流速（EDV）、血管搏动指数（PI）和阻力指数（RI）进行检测。结果 颈内动脉系和椎-基底动脉系均随着高血压分级的增加,PSV和EDV减低,PI和RI增加。颈内动脉系的PSV和EDV在2级高血压组减低,椎-基底动脉系在1级高血压组EDV减低,RI增加。椎-基底动脉系除3级高血压组的颅内段大脑后动脉和颅外段椎动脉₂的PI及RI呈负相关外,两系的2级和3级高血压组的颅内、外参数相关均呈正相关。结论 2级高血压患者颈内动脉系PSV和EDV降低,1级高血压患者椎-基底动脉系EDV降低和RI增高。颅内、外血管的血流动力学指标仅在2级高血压以上有相关性。