Contrast-enhanced color Doppler US in malignant portal vein thrombosis

Purpose: To assess the role of contrast-enhanced color Doppler US in the differential diagnosis of benign and malignant portal vein thrombosis.Material and Methods: Fifty-six patients with portal vein thrombosis underwent color and power Doppler US examination before and after i.v. injection of galactose-palmitic acid suspension. The criterion for diagnosing the presence and extension of thrombosis was the lack of visualization of portal vein flow in a segment of the portal vein. The criterion for diagnosing malignant portal vein thrombosis was the detection of pulsatile arterial flow, either hepatopetal or hepatofugal, in the thrombus. The US data were correlated with the types of portal vein thrombosis.Results: Among the 56 patients, there were 40 benign and 16 malignant portal thromboses. Unenhanced Doppler US detected continuous blood flow in 24 benign thromboses and pulsatile in 3 malignant thromboses. No flow, either continuous or pulsatile, was detected in 16 cases with benign thrombosis and in 13 cases with malignant thrombosis. Contrast-enhanced Doppler US allowed to assess pulsatile flow in 15 cases with malignant thrombosis (94%). The use of pulsatile flow as diagnostic criterion of malignant thrombosis yielded a sensitivity of 57% and a specificity of 95% with conventional Doppler US, whereas contrast-enhanced US achieved a sensitivity of 94% and a specificity of 100%.Conclusion: Contrast-enhanced Doppler US is a reliable diagnostic tool for assessing malignant portal vein thrombosis.     

Usefulness of echo-color Doppler in differentiating parathyroid lesions from other cervical masses

. The aim of our study was to clarify possible differential color Doppler US features between parathyroid lesions and other cervical masses. A total of 56 parathyroid lesions in 54 patients with primary hyperparathyroidism were preoperatively examined with color Doppler sonography. Color Doppler flow patterns were compared with those of 72 thyroid nodules and 20 cervical lymph nodes. In 38 parathyroid lesions a correlation between color Doppler patterns and size, location, and pathological findings was performed. Color Doppler sonography showed five vascular distribution patterns: pattern I, absence of flow; pattern II, focal peripheral flow (“vascular pole”) with arterial Doppler spectrum; pattern III, peripheral flow; pattern IV, internal flow (“parenchymal pattern”); pattern V, peripheral and intranodular flow. Pattern I was not specific for any cervical lesion considered. Conversely, pattern IV was observed solely in parathyroid lesions, and pattern II was observed in only one nonparathyroid lesion (thyroid nodule). Mixed pattern (pattern V) was observed solely in thyroid nodules. In addition, pattern III was a characteristic finding of thyroid nodules and was observed in only one parathyroid lesion. Color Doppler patterns of the parathyroid masses did not correlate with the size of the lesion or pathological findings, but only with the location of the gland. Our study showed that color Doppler assessment of parathyroid lesions is a useful integration of gray-scale US and may be helpful in distinguishing parathyroid lesions from other cervical masses. Received 6 November 1995; Revision received 9 January 1996; Accepted 19 February 1996     

Contrast-enhanced power Doppler ultrasonography of the metacarpophalangeal joints in rheumatoid arthritis

The aim of this study was to examine, with dynamic contrast-enhanced MRI as the reference, if contrast-enhanced power Doppler ultrasonography (CE PDUS) of rheumatoid arthritis (RA) metacarpophalangeal (MCP) joints provides additional information for evaluation of synovial inflammation compared with PDUS. One MCP joint in each of 15 RA patients and 3 healthy control persons were examined with PDUS before and after intravenous bolus Levovist contrast injection. Corresponding rates of early synovial enhancement (RESE), previously shown to be closely related to histopathological synovitis, were calculated from dynamic contrast-enhanced MR images obtained the same day. Prior to ultrasonography, the joint was evaluated clinically. Levovist increased the flow signal in 7 of 9 joints with pre-contrast flow-signal and in 0 of 9 without pre-contrast signal. No healthy controls showed CE PDUS signal. The results of CE PDUS and dynamic MRI were closely related: RESE in joints with CE PDUS signal was significantly higher than in joints without CE PDUS signal (Mann-Whitney test, p<0.001). Among the patients with pre-contrast PDUS signal no statistically significant difference in RESE values was found between joints with and without post-contrast flow-signal increase. No correlation was found between clinical examination and CE PDUS. Based on comparisons with dynamic contrast-enhanced MRI, PDUS appears to be reliable for assessment of synovitis in RA MCP joints. Intravenous contrast injection may provide additional information in selected cases but did not in the present study increase the sensitivity of the method. Electronic Publication     

High-resolution and color Doppler ultrasonography of cervical lymphadenopathy in children

Purpose: To assess the frequency of high-resolution and color Doppler sonographic findings in the most common diseases of childhood manifested with cervical lymphadenopathy at initial presentation.Material and Methods: High-resolution and color Doppler US were performed in 103 and 43 children respectively, with cervical lymphadenopathy at initial presentation. Sonomorphology and intranodal vascularity were assessed. Final diagnoses, based on biopsy or clinical and sonographic follow-up, included: Reactive hyperplasia (n=34), infectious mononucleosis (n=20), lymphoma (n=11), bacterial (n=28), tuberculous (n=5) and cat-scratch disease (CSD, n=5) lymphadenites.Results: Round shape (L/S2. Wide hilum conforming to nodal shape characterized reactive hyperplasia (94%) and infectious mononucleosis whereas absent or narrow hilum was frequent in lymphoma (100%) and bacterial lymphadenitis (60%). Central irregular hyperechogenic areas, blurred margins and central necrosis were most frequent in bacterial, tuberculous and CSD lymphadenites. On color Doppler US, hyperplastic nodes more frequently exhibited a solitary hilar vessel (48%), whereas infectious mononucleosis nodes had a central radial pattern (75%). Bacterial lymphadenitis presented with a variety of vascular patterns.Conclusion: Although individual sonographic signs are not specific, the categorization and combination of findings might be highly suggestive of diagnosis of the underlying disease presenting with cervical lymphadenopathy.     

Contrast-enhanced ultrasonography compared to gray-scale and power doppler in the diagnosis of peripheral lymphadenopathy

Objectives

The aim of the study was to evaluate the ability of contrast-enhanced ultrasonography compared to gray-scale B-mode and power Doppler in distinction between benign and malignant lymphadenopathy.

Methods

In a prospective study ultrasonography was performed in 133 patients with superficial lymphadenopathy (73 men, 60 women; mean age of 51 years, range: 18–86 years), who were examined for palpable mass in the neck, axilla or groin (104/133) and for clinical suspicion of lymphoma on the basis of positive PET/CT (29/133). 133 nodes were examined, subsequently preoperatively localized under ultrasound guidance and surgically removed; longitudinal to transverse ratio, location of nodal vessels by power Doppler and pattern of enhancement by contrast-enhanced ultrasonography with 1.5 ml intravenous bolus of sulphur hexafluoride contrast agent were documented. The ultrasound findings were compared with the histology.

Results

Of all the nodes extirpated, 33 were benign, 100 were malignant (40 metastases, 60 lymphomas). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of conventional techniques were 72%, 63.6%, 85.7%, 42.9%, 67.8% for longitudinal to transverse ratio; 73%, 60.6%, 84.9%, 42.6%, 68.3% for power Doppler versus 98.0%, 54.5%, 86.7%, 90.0%, 76.3% for contrast-enhanced ultrasonography according to Receiver Operating Characteristic analysis.

Conclusions

Receiver Operating Characteristic analysis confirmed higher degree of diagnostic accuracy of contrast-enhanced ultrasonography in comparison with conventional techniques. Evaluation of nodal perfusion after intravenous administration of microbubble contrast agent can be helpful in differentiation of benign from malignant nodes.     

彩色多普勒超声对腋窝淋巴结病变的诊断价值

目的探讨彩色多普勒超声诊断腋窝淋巴结病变的价值。方法应用彩色多普勒超声观察与测量42例良性、36例恶性肿大淋巴结长径与前后径(L/S)比值,内部回声,CDFI,血流分布及PWD频谱特征。结果良性淋巴结L/S比值大于1.8,平均为(2.02±0.24),RI为(0.62±0.08);恶性肿大淋巴结L/S比值小于1.8,平均为(1.50±0.29),RI为(0.82±0.07),二项指标比较均具有显著性差异(P<0.05),良性淋巴结血流分支细少,走行规律,低阻力,而恶性肿大淋巴结呈不规则扭曲、紊乱血流,高阻力。结论彩色多普勒超声对腋窝肿大淋巴结良、恶性的鉴别诊断具有较大意义,可作为首选方法。     

彩色多普勒超声对颈动脉体瘤的诊断价值

 目的 探讨彩色多普勒超声在颈动脉体瘤诊断中的应用价值.方法 回顾性分析7例颈动脉体瘤患者的二维及彩色多普勒超声表现.所有病例均经手术病理证实.结果 颈动脉体瘤二维超声表现为颈动脉分叉处见实质性低回声肿块,边界清晰,边缘规则或呈分叶状.肿瘤较小时,多位于颈总动脉分叉处,使颈内、外动脉间距增大,形状多较规则;肿瘤较大时,常围绕血管生长.彩色多普勒超声均可见肿瘤内有较丰富的彩色血流信号,以动脉血流为主;CDFI还能清晰显示肿瘤与颈动脉的关系.结论 二维及彩色多普勒超声对诊断颈动脉体瘤具有无创、安全、特异性、准确性高的特点,有利于同颈部其他性质包块的鉴别诊断,是目前颈动脉体瘤诊断的首选方法.     

Contrast-enhanced color Doppler ultrasound characteristics in hypervascular breast tumors: comparison with MRI

The aim of this study was to evaluate the accuracy of contrast-enhanced color Doppler ultrasound (CE-US) in comparison with contrast-enhanced MR imaging (CE-MRI) in the discrimination of hypervascularized breast tumors. An additional CE-US of the breast was preoperatively performed in 40 patients with a hypervascular breast lesion detected on CE-MRI. The presence of blood flow signals and the morphological characteristics of the vessels in the breast lesions were evaluated pre- and post-contrast administration, as well as the dynamic aspects of the Doppler signal, including time interval to maximum signal enhancement and persistence of the signal enhancement. Twenty-three carcinomas and 17 fibroadenomas were explored. Considering initial signal enhancement > 100 % after the administration of contrast material as a criterion suggesting malignancy, CE-MRI showed a sensitivity of 100 % and a specificity of 76.5 % in the detection of malignant breast tumors. Color Doppler signals were consistently demonstrated in all carcinomas and in 68.7 % of fibroadenomas after the administration of Levovist, with CE-US showing a sensitivity of 95.6 % and a specificity of 5.9 %. Neither the mean number of vessels per tumor, nor the location of vessels, the time to maximum increase of the Doppler signal or the persistence of signal enhancement showed significant differences between benign and malignant lesions. Additional CE-US does not increase the low specificity of MRI in patients with hypervascularized breast tumors. Received: 17 July 2000 Revised: 22 August 2000 Accepted: 24 August 2000     

小儿髋关节暂时性滑膜炎的彩色多普勒超声表现

目的:探讨彩色多普勒超声在小儿髋关节暂时性滑膜炎的临床价值。方法:选取髋关节暂时性滑膜炎患儿38例,应用彩色多普勒超声对患儿治疗前后髋关节滑膜内细小血管的血供情况和频谱多普勒进行血流检测评价。结果:患儿治疗前,肿胀组与积液组滑膜增厚型的病例患侧髋关节滑膜内血流信号较健侧明显丰富;肿胀组血流速度升高,积液组血流速度减低。治疗后1周,肿胀组及积液组患髋滑膜内的血流信号较治疗前有所下降;肿胀组血流速度减低,积液组血流速度升高。治疗后2周,两组患髋滑膜内血流信号基本同健侧。结论:多普勒超声能监测小儿髋关节暂时性滑膜炎髋关节滑膜内的血供改变,对疾病的诊断和疗效观察有重要的应用价值。     

妇产科急症的彩超诊断价值

目的 探讨彩超对妇产科急症的诊断价值。方法 对96例妇产科急症行彩超检查，与经手和病理证实的检查结果进行分析。结果 宫外孕41例，不全流产30例，先兆流产7例，卵巢黄体囊肿破裂5例，卵巢肿瘤蒂扭转11例、子宫穿孔2例，超声诊断符合率分别为92．7％(39／41)、93．3％(28／30)、100％(7／7)、60％（3／5)、72．7％(8／11)、100％(2／2）。结论 彩超对妇产科急症诊断准确率高，具有特异性且迅速无痛苦，为妇产科急症首选检查方法。     

经胸心脏彩色多普勒超声和常规心电图诊断心脏病的对比分析

目的 对比分析经胸心脏彩色多普勒超声和常规心电图诊断心脏病的临床应用价值.方法 选取2018年1月至2020年1月本院就诊的88例心脏病患者作为研究对象,均行经胸心脏彩色多普勒超声、常规心电图诊断.对比两种诊断方式的临床诊断价值.结果 经胸心脏彩色多普勒超声诊断的左心室增大检出率、左心室肥厚检出率、主动脉弹性减退检出率...     

彩色多普勒超声在糖尿病动脉硬化中的诊断价值

目的探讨彩色多普勒超声对糖尿病动脉硬化的诊断意义．并总结糖尿病患者动脉硬化的特点。方法选取80例糖尿病患者和75名健康体检者做对照研究,所有病例均使用彩色多普勒超声检查颈总动脉（CCA）、颈内动脉（ICA）、锁骨下动脉（sa）、无名动脉（IA）、股总动脉（FA）、股浅动脉（SFA）、胴动脉（PA）、足背动脉（DA）,测量动脉内径、内中膜厚度、收缩期最大流速、阻力指数、有无斑块形成及斑块的性质。结果糖尿病组CCA内径、CCA内中膜厚度、ICA内径、ICA内中膜厚度、ICA血流阻力指数、sA内径、FA内径、PA内中膜厚度等参数较健康组明显增大,2组间比较差异有统计学意义（P〈0．05）;糖尿病组CCA、SA、FA斑块的发生率明显高于健康组（P〈O．05）;动脉管壁斑块的性质,2组差异无统计学意义。结论糖尿病组血管硬化的发病率明显较高,其血管病变范围更广泛,中、小动脉也明显受累,尤以近端动脉为著;各大血管病变以后壁及血管分支处多见．较前壁有显著差异．     

US imaging and color Doppler in patients undergoing inhibitory therapy with calcitriol for secondary hyperparathyroidism

The aim of this study was to evaluate the changes in volume, structure, and flow pattern of parathyroid glands in uremic patients with secondary hyperparathyroidism treated with long-term intravenous calcitriol (CTL) therapy. Ultrasonography was used to follow-up volume changes occurring in 18 enlarged glands in 11 patients during an 18-month period; in 6 of these cases, 11 glands were followed-up also with color-Doppler to monitor variations in flow pattern. Vascularization was classified using three grades: grade 0=no color signal; grade I=vessels covering less than 50% of glandular cross-sectional area; grade II=vascular signals covering more than 50% of glandular cross-sectional area. No significant changes in volume were demonstrated during the 18 months of follow-up. On the contrary, significant decrease in flow was observed with almost complete disappearance of color-Doppler signals. This finding related well with the observed decrease in parathormone blood levels. Lack of volume changes during medical therapy demonstrates the inability of US alone to monitor the effect of this treatment on the parathyroid glands. Conversely, the observed intraglandular flow reduction indicates the possibility to use color Doppler to monitor the effects of CLT in uremic hemodialyzed patients with secondary hyperparathyroidism. This imaging procedure can be proposed for follow-up of the response of the parathyroid glands to therapy.     

Contrast-enhanced power Doppler US in the diagnosis of renal pseudotumors

The term "pseudotumor" is used to refer to several anatomic variants that can simulate a renal mass, the most frequent of which are hypertrophied column of Bertin, persistence of fetal lobation, and the dromedary or splenic hump. We describe the findings of power Doppler US after the ultrasound contrast agent (Levovist, Schering, Berlin, Germany) administration in 4 patients with a renal focal lesion in whom gray-scale and baseline power Doppler US was not able to certainly differentiate pseudotumor from neoplasm.     

彩超在喉部良性占位性病变诊断中的应用价值

目的:评价彩超对喉良性占位性病变的诊断价值。方法:对59例喉良性病变住院病人术前行彩色超声检查并与喉内镜及手术、病理对照。结果:彩超对声带息肉的检出率为100%,能较清晰显示喉部良性病变的大小、部位、内部回声及血流情况、病变范围及其与声带边缘的关系。结论:彩超对喉部良性病变有较高的诊断符合率,特别是对难以配合的儿童患者及其他常规检查难以配合的患者则是最佳检查方法,对临床选择喉显微手术方式具有指导意义。但是要求操作者必须手法娴熟且熟悉喉部解剖。     

彩色多普勒超声在子宫动脉化疗栓塞术治疗子宫瘢痕妊娠中的应用

目的:探讨彩色多普勒超声在子宫动脉栓塞术治疗子宫瘢痕妊娠中的应用价值。方法:回顾性分析彩色多普勒超声在30例子宫瘢痕妊娠患者子宫动脉化疗栓塞术前的诊断价值、对栓塞术后的疗效评价及超声引导下刮宫术及术后随访中的作用。结果:术前诊断:超声显示25例表现为子宫峡部包块型,5例表现为子宫峡部孕囊型;27例孕囊周边有较丰富的血流信号,25例阻力指数<0.5;峡部最薄处厚度(2.31±0.42)mm。子宫动脉栓塞术后24～72h超声表现:29例包块内或孕囊周边均未见明显血流信号,1例仍可见丰富血流信号,再次行子宫动脉栓塞术,24h后复查超声示病灶内血流消失。栓塞术后超声成功引导刮宫术,超声随访所有患者两个月内包块均消失,月经恢复。结论:超声既能准确诊断CSP又可对子宫动脉栓塞术后的疗效进行全面评价并引导清宫术及术后有效随访,值得进一步推广应用。     

肝肿瘤灰阶超声造影与彩色多普勒超声检查对比分析

目的 对比灰阶超声造影和彩色多普勒超声在诊断肝肿瘤中的应用价值.资料与方法 34例肝肿瘤患者分别行灰阶超声造影及彩色多普勒超声造影,对血流显示率、微血管血流显示率行临床监测及综合调查分析.结果 灰阶超声造影及彩色多普勒造影血流显示率分别为100.0％ (34/34)、91.2％ (31/34),差异无统计学意义(x2=1.39,P＞0.05);微血管血流显示率分别为97.1％(33/34)与29.4％ (10/34),差异有统计学意义(x2=33.46,P＜0.01).结论 实时灰阶超声造影法具有对低速血流敏感、对肿瘤微血管的显示敏感、空间分辨力较好、不存在伪像等优势,可用于观察肿瘤实质内的微血管灌注,较多普勒造影法更有助于鉴别诊断肝肿瘤.     

灰阶超声造影在肝脏局灶性病变诊断中的应用

目的探讨实时灰阶超声造影在肝脏局灶性病变诊断与鉴别诊断中的应用价值。方法回顾性分析36例肝脏局灶性病变患者的超声造影表现,评价病灶增强时相及其形态学特征,并进行血流动力学分析。同时与CDFI进行比较,部分病例与CT进行对照。结果不同性质占位性病变具有不同的造影增强表现;与CDFI相比,超声造影可明显提高病灶血流显示率;同时,对于直径≤1.0cm病灶,检出率明显提高。结论超声造影在肝脏局灶性病变诊断和鉴别诊断中具有重要意义。     

超声造影诊断肾脏占位性病变的临床研究

目的:探讨超声造影在肾脏占位性病变中的临床应用价值。方法:对16例经手术病理或随访证实的肾脏占位性病变患者行超声造影,观察并分析病灶对比剂灌注时相和变化规律。结果:9例肾透明细胞癌,超声造影表现多种多样,与正常肾皮质相比较:快进7例,同进2例,快退3例,同退3例,慢退3例;与正常肾皮质强化程度相比较:6例高强化,3例等强化。3例肾囊性病灶,超声造影轮廓较二维超声清晰,但内部始终未见强化。2例肾血管平滑肌脂肪瘤表现为慢进慢退,回声呈等、低强化表现。2例肾柱肥大超声造影增强动态变化时间、强度与正常肾实质一致。结论:超声造影能够实时观察肾脏占位性病变的血流灌注情况,对肾脏占位性病变的诊断和鉴别诊断具有较高的临床应用价值。     

甲状腺结节的二维及彩色多普勒超声诊断研究

目的：探讨二维及彩色多普勒超声对甲状腺良、恶性结节的诊断及鉴别诊断价值。方法：120例甲状腺结节经二维超声了解其声像图表现，然后用彩色多普勒检查，观察结节内部及周边血流分布情况，并将其分为4级。结果：120例302个甲状腺结节中，良性结节264个，恶性结节38个。二维超声显示：恶性结节以实性低回声为主，内可见砂粒样钙化，边界不清，无声晕及包膜；良性结节以等、高回声及囊性、囊实性结节为主，形态规则，边界清，多有声晕及包膜。彩色多普勒超声显示：恶性结节的血流显示率明显高于良性结节，收缩期最高血流速度及阻力指数总体上高于良性结节，且以Ⅱ、Ⅲ级血流为主。结论：二维及彩色多普勒超声诊断甲状腺良、恶性结节准确率高。具有较大的临床应用价值。