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.
Arteries* ; Constriction, Pathologic ; Lower Extremity* ; Peripheral Arterial Disease ; Ultrasonography ; Ultrasonography, Doppler* ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Pulsed ; Varicose Veins ; Venous Thrombosis

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.
Caregivers* ; Delivery of Health Care ; Female ; Free Tissue Flaps* ; Humans ; Skull ; Thigh ; Ultrasonography, Doppler, Pulsed ; Wounds and Injuries ; Young Adult

OBJECTIVETo evaluate the accuracy of the time interval between the onset of early transmitral flow velocity (E) and that of early diastolic mitral annular velocity (e') (TE-e') measured by dual Doppler echocardiography in the diagnosis of diastolic dysfunction.

METHODSSeventy-seven coronary heart disease patients with preserved systolic function underwent a echocardiographic study. Early transmitral flow velocity E and early diastolic mitral annular velocity e' were simultaneously recorded by dual Doppler echocardiography. The E/e' and TE-e' were calculated and compared with the left ventricular end diastolic pressure (LVEDP), which was measured invasively. The validity of TE-e', E/e' and their combination was analyzed in estimating left ventricular dysfunction (LVEDP ≥12 mmHg).

RESULTSThe single-beat E/e' and TE-e' were correlated with the LVEDP (r=0.79 and 0.42, respectively, P<0.001). Receiver-operating characteristic analysis showed that the optimal cut-off for TE-e' was 38 ms (sensitivity 54%, specificity 79%, AUC 0.71) and that for E/e' was 9.2 (sensitivity 74%, specificity 81%, AUC 0.87) for diagnosis of left ventricular diastolic dysfunction. The combined cut-offs of TE-e'≥38 ms and E/e'≥9.2 had a sensitivity of 100% and a specificity of 62% in diagnosing left ventricular diastolic dysfunction with an AUC of 0.96.

CONCLUSIONIn patients with coronary heart disease, the simultaneous recording of TE-e' by dual Doppler echocardiography can accurately estimate diastolic dysfunction, and its combination with E/e' can further improve the diagnostic accuracy.

Aged ; Coronary Disease ; diagnostic imaging ; physiopathology ; Echocardiography, Doppler, Pulsed ; Female ; Humans ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnostic imaging ; physiopathology

This study was conducted to evaluate the usefulness of coronary arterial profiles from normal dogs (11 animals) and canines (six dogs) with experimental myocardial infarction (MI) induced by ligation of the left coronary artery (LCA). Blood velocity of the LCA and right coronary artery (RCA) were evaluated following transthoracic pulsed-wave Doppler echocardiography. The LCA was observed as an infundibular shape, located adjacent to the sinus of Valsalva. The RCA appeared as a tubular structure located 12 o'clock relative to the aorta. In normal dogs, the LCA and RCA mean peak diastolic velocities were 20.84 +/- 3.24 and 19.47 +/- 2.67 cm/sec, respectively. The LCA and RCA mean diastolic deceleration times were 0.91 +/- 0.14 sec and 1.13 +/- 0.20 sec, respectively. In dogs with MI, the LCA had significantly (p < 0.01) lower peak velocities (14.82 +/- 1.61 cm/sec) than the RCA (31.61 +/- 2.34 cm/sec). The RCA had a significantly (p < 0.01) rapid diastolic deceleration time (0.71 +/- 0.06 sec) than that found in the LCA (1.02 +/- 0.22 sec) of MI dogs. In conclusion, these profiles may serve as a differential factor for evaluating cardiomyopathy in dogs.
Animals ; Blood Flow Velocity/*veterinary ; Coronary Vessels/surgery/*ultrasonography ; Dog Diseases/*diagnosis ; Dogs/*physiology ; Echocardiography, Doppler, Pulsed/standards/*veterinary ; Female ; Male ; Myocardial Infarction/diagnosis/*veterinary

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.
Carcinoma, Renal Cell* ; Humans ; Kidney ; Kidney Failure, Chronic* ; Nephrectomy ; Ultrasonography, Doppler* ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Pulsed

OBJECTIVETo evaluate the diagnostic value of ultrasonography in combination with mammography for breast cancer within 2 cm.

METHODSThe 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.

RESULTSNine 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.

CONCLUSIONThe combination of ultrasonography and mammography can increase the diagnostic accuracy for breast cancer within 2 cm.

Breast Neoplasms ; diagnostic imaging ; pathology ; Early Detection of Cancer ; Female ; Humans ; Mammography ; instrumentation ; methods ; Molybdenum ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Pulsed ; Ultrasonography, Mammary ; methods

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.
Animals ; Dogs/*anatomy & histology ; Female ; Heart Ventricles/*ultrasonography ; Male ; Mitral Valve/*ultrasonography ; Ultrasonography, Doppler, Pulsed/methods/*veterinary

BACKGROUND AND OBJECTIVES: Irregular RR intervals in atrial fibrillation (AF) make beat-to-beat changes in left ventricular (LV) systolic performance. Early diastolic mitral annular velocity (E') is one of the well-established parameters for evaluating LV diastolic function. The relation between RR intervals and E's is unknown. The aim of this study was to observe the influence of continuous changes in RR interval on the parameter for diastolic function in AF. SUBJECTS AND METHODS: Echocardiography was performed in 117 patients with AF. E' was adjusted for the effect of pre-preceding RR interval (RR-2) using the logarithmic equation between RR-2 and E'. The logarithmic equation between adjusted E' and preceding RR interval (RR-1) was calculated. RESULTS: The slope in the relation between RR-1 and E' varied from -2.5 to 2.6. The slope was lower (more likely negative) in patients with higher ratio of early diastolic mitral flow velocity (E) to E' (r=-0.21, p=0.023), ischemic heart disease (IHD, r=0.21, p=0.026), and higher systolic blood pressure (r=-0.19, p=0.046). When patients were divided into these 3 groups on the basis of slope, the lowest slope group (<-0.55, n=39) was associated with higher E'/E (p=0.004) and IHD (p=0.018) compared with the highest slope group (>0.57, n=39). The slope with regards to the relationship between RR-2 and E' also varied from -3.4 to 3.1. CONCLUSION: Changes in RR intervals had variable effects on E's according to clinical variables in AF.
Atrial Fibrillation ; Blood Pressure ; Echocardiography ; Echocardiography, Doppler, Pulsed ; Electrocardiography ; Heart Rate ; Humans ; Myocardial Ischemia ; Ventricular Function, Left

BACKGROUND: Doppler echocardiographic measurements of both valves during intrauterine life can be used to calculate peak early filling velocity (E)/late peak atrial filling velocity (A) ratio as a single index of diastolic performance. The purposes of this study were to estimate the changes in atrioventricular valve flow from gestational age 37-40 weeks to 1 month of postnatal life and to clarify the difference in right and left ventricular diastolic filling patterns. METHODS: Atrioventricular flow waves were analyzed in 24 full-term pregnant women by fetal echocardiography. Postnatal follow-up studies were performed at 1 hour, 6 hours, 24 hours, 3 days, 1 week and 1 month. In each time point, pulsed Doppler echocardiography was used to interrogate Doppler waveform of E velocity, A velocity, total area under the curve (time velocity integral) and heart rate. RESULTS: Mitral E/A ratio significantly increased from 0.7 +/- 0.1 before birth to 1.0 +/- 0.3 at postnatal 1 hour, 1.0 +/- 0.2 at 1 week, and 1.5 +/- 1.0 at 1 month. Tricuspid flow E/A ratio was 0.8 +/- 0.3 before birth, 0.8 +/- 0.1 at 1 hour, 0.8 +/- 0.2 at 3 days, 0.9 +/- 1.0 at 1 month. Time velocity integral of tricuspid flow was significantly higher than that of mitral flow before birth, but there was no difference after birth. CONCLUSION: The dominance of mitral A wave before birth was changed very quickly after birth to the dominance of E wave, but the dominance of tricuspid A wave was maintained at 1 month. Diastolic function and compliance of mitral valve were better than those of the tricuspid valve after birth.
Compliance ; Echocardiography ; Echocardiography, Doppler, Pulsed ; Female ; Follow-Up Studies ; Gestational Age ; Heart ; Humans ; Mitral Valve ; Parturition ; Pregnant Women ; Tricuspid Valve

OBJECTIVETo investigate the characteristics of pulmonary valve annular motion by quantitative tissue velocity imaging (QTVI) in children with pulmonary hypertension.

METHODSThe pulmonary valve annular motion was assessed by QTVI in 32 children with pulmonary hypertension and 32 healthy children. The QTVI sample volume was set at the point of pulmonary valve annulus to acquire speed-time curve and the parameters from the views of parasternal aortic short-axis or subxiphoid right ventricular outflow long-axis. The parameters of pulmonary valve annular motion of children with pulmonary hypertension were compared to those of normal children.

RESULTSThe speed-time curve of pulmonary valve annulus was similar with that of tricuspid annulus in normal children. Compared to normal children, the ratio of Ea/Aa (the velocity parameter of pulmonary valve annular motion) was significantly lower in children with pulmonary hypertension (0.68 ±0.36 Compared with 1.18 ±0.43, P<0.001); and the value of QTVI-Tei index at the pulmonary annulus was significantly higher (0.82 ±0.34 Compared with 0.37 ±0.05, P<0.001). The QTVI-Tei index was positively correlated with the resistance of pulmonary vessel (r=0.556, P<0.001).

CONCLUSIONThe ratio of Ea/Aa is decreased, the value of QTVI-Tei index is increased and QTVI-Tei index is positively correlated with the resistance of pulmonary vessel in children with pulmonary hypertension.

Child, Preschool ; Echocardiography, Doppler, Pulsed ; Female ; Humans ; Hypertension, Pulmonary ; diagnostic imaging ; physiopathology ; Infant ; Infant, Newborn ; Male ; Pulmonary Valve ; diagnostic imaging ; physiopathology