The aim of this study was to compare lower limb blood flow in asymptomatic diabetic patients with early-stage peripheral artery disease (PAD) and non-diabetic controls using duplex ultrasound parameters. This was a co...The aim of this study was to compare lower limb blood flow in asymptomatic diabetic patients with early-stage peripheral artery disease (PAD) and non-diabetic controls using duplex ultrasound parameters. This was a comparative cohort study of lower limb blood flow in 35 Black-African diabetic patients (25 females and 10 males with early-stage PAD median age 54 [IQR, 47 - 61] years;median HbA<sub>1c</sub> 6.3 [IQR, 5.7 - 8.0]%<sub></sub>;BMI 29.2 ± 6.7;ABI 1.1 ± 0.1) and 36 non-diabetic controls (28 females and 8 males;median age 54 [IQR, 47 - 61] years;median HbA<sub>1c</sub> 6.3 [IQR, 5.7 - 8.0] %, BMI 29.2 ± 6.7;ABI 1.1 ± 0.1). Peak systolic velocity (PSV), pulsatility index (PI) and resistive index (RI), were utilised to compare blood flow in the popliteal arteries (PA), anterior tibial arteries (ATA) and posterior tibial arteries (PTA) in addition to ankle brachial index. All the ultrasound parameters showed good (ICC ≥ 0.7;0.50 - 0.85, 95% CI) to excellent (ICC = 1.0;1.0 - 1.0, 95% CI) reliability within groups as well as acceptable variability () other than pulsatility index of the anterior tibial artery within diabetic patients (11.1% CV). PSV, RI and PI were significantly and meaningfully higher (P;d ≥ 0.33), in diabetic patients compared to non-diabetic controls except for PI - PTA (P = 0.72;d = 0.11). Differences in PSV and RI highlighted the effects of early-stage PAD on lower limb blood flow of diabetic patients. In contrast, the effects of early-stage PAD on blood flow were not demonstrated in the PTA and ATA of diabetic patients by PI.展开更多
AIM: To compare time average maximum mean velocity(TAMV) and peak systolic velocity(PSV) criteria of Trans Cranial Doppler(TCD) in their ability to predict abnormalities on magnetic resonance imaging(MRI)/magnetic res...AIM: To compare time average maximum mean velocity(TAMV) and peak systolic velocity(PSV) criteria of Trans Cranial Doppler(TCD) in their ability to predict abnormalities on magnetic resonance imaging(MRI)/magnetic resonance angiogram(MRA) in patients with sickle cell disease. METHODS: A retrospective evaluation was performed of the outcomes in all patients with a Transcranial Doppler examination at our institution since the implementation of the hospital picture archiving and communication system(PACS) system in January 2003 through December 2012. All ultrasound imaging exams were performed by the same technologist with a 3 MHz transducer. Inclusion criteria was based upon the Transcranial Doppler procedure code in our PACS which had an indication of sickle cell disease in the history. The patient's age and gender along with the vessel with the highest time averaged mean velocity as well as the highest peak systolic velocity was recorded for analysis. A subset of the study cohort also had subsequent MR imaging and Angiograms performed within 6 mo of the TCD examination. MRI results were categorized as having a disease related abnormality(vessel narrowing, collateral formation/moya-moya, or abnormal fluid attenuation inversion recovery signal in parenchyma indicative of prior stroke) or normal. The MRI results formed the comparison standards for TCD exams in evaluating intracranial injury. Sensitivity and specificity for the two TCD criteria(TAMV and PSV) were calculated to determine which could be a better predictor for intracranial vasculopathy /clinically occult strokes.RESULTS: The study cohort for our institution was 110patients with a total of 291 TCD examinations. These patients had a mean age of 7.6 years with a range from 2-18 years of age. Sixty-two of the 110 patients(56%) had two or more TCD exams. Thirty-seven patients(34%) had at least one MRI following a TCD examination. Of the 291 TCD examinations, 46(16%) were conditional or abnormal by TAMV criteria. One hundred and sixteen(40%) were conditional 展开更多
BACKGROUND： Small for gestational age （SGA） has high frequency which increases the risk of long-term adverse outcomes. Thus the aim of this study was to evaluate peak systolic velocity Doppler of middle cerebral ar...BACKGROUND： Small for gestational age （SGA） has high frequency which increases the risk of long-term adverse outcomes. Thus the aim of this study was to evaluate peak systolic velocity Doppler of middle cerebral artery （MCA） in SGA fetus in order to find appropriate method to diagnosis SGA sooner. MATERIALS and METHODS： This prospective longitudinal study was conducted on 90 pregnant women with a diagnosis of SGA fetus and 90 pregnant women with normal fetus. Then MCA and umbilical artery assessment were performed for all subjects and compared between two groups. RESULTS： Doppler assessment showed that umbilical artery PI was significantly higher in SGA group as compared to normal group （1.114-0.37 vs 0.984-0.18, P = 0.003）, while MCA PI was significantly lower in SGA group （1.77±0.44 vs 1.92±0.47, P = 0.028）. On the other hand, PSV did not differ between the groups （P = 0.592）. Moreover, we found that PSV was more in SGA group by grouping maternal age （〈 27 years） （P = 0.006）, and gestational age （〉 34 weeks） （P 〈 0.001）. CONCLUSION： The results of this study suggest that MCA PI decreased significantly in SGA fetuses, while UA PI increased in this group. Moreover, PSV increased in this group when evaluated in different subgroups （based on maternal age and gestational age）.展开更多
文摘The aim of this study was to compare lower limb blood flow in asymptomatic diabetic patients with early-stage peripheral artery disease (PAD) and non-diabetic controls using duplex ultrasound parameters. This was a comparative cohort study of lower limb blood flow in 35 Black-African diabetic patients (25 females and 10 males with early-stage PAD median age 54 [IQR, 47 - 61] years;median HbA<sub>1c</sub> 6.3 [IQR, 5.7 - 8.0]%<sub></sub>;BMI 29.2 ± 6.7;ABI 1.1 ± 0.1) and 36 non-diabetic controls (28 females and 8 males;median age 54 [IQR, 47 - 61] years;median HbA<sub>1c</sub> 6.3 [IQR, 5.7 - 8.0] %, BMI 29.2 ± 6.7;ABI 1.1 ± 0.1). Peak systolic velocity (PSV), pulsatility index (PI) and resistive index (RI), were utilised to compare blood flow in the popliteal arteries (PA), anterior tibial arteries (ATA) and posterior tibial arteries (PTA) in addition to ankle brachial index. All the ultrasound parameters showed good (ICC ≥ 0.7;0.50 - 0.85, 95% CI) to excellent (ICC = 1.0;1.0 - 1.0, 95% CI) reliability within groups as well as acceptable variability () other than pulsatility index of the anterior tibial artery within diabetic patients (11.1% CV). PSV, RI and PI were significantly and meaningfully higher (P;d ≥ 0.33), in diabetic patients compared to non-diabetic controls except for PI - PTA (P = 0.72;d = 0.11). Differences in PSV and RI highlighted the effects of early-stage PAD on lower limb blood flow of diabetic patients. In contrast, the effects of early-stage PAD on blood flow were not demonstrated in the PTA and ATA of diabetic patients by PI.
文摘AIM: To compare time average maximum mean velocity(TAMV) and peak systolic velocity(PSV) criteria of Trans Cranial Doppler(TCD) in their ability to predict abnormalities on magnetic resonance imaging(MRI)/magnetic resonance angiogram(MRA) in patients with sickle cell disease. METHODS: A retrospective evaluation was performed of the outcomes in all patients with a Transcranial Doppler examination at our institution since the implementation of the hospital picture archiving and communication system(PACS) system in January 2003 through December 2012. All ultrasound imaging exams were performed by the same technologist with a 3 MHz transducer. Inclusion criteria was based upon the Transcranial Doppler procedure code in our PACS which had an indication of sickle cell disease in the history. The patient's age and gender along with the vessel with the highest time averaged mean velocity as well as the highest peak systolic velocity was recorded for analysis. A subset of the study cohort also had subsequent MR imaging and Angiograms performed within 6 mo of the TCD examination. MRI results were categorized as having a disease related abnormality(vessel narrowing, collateral formation/moya-moya, or abnormal fluid attenuation inversion recovery signal in parenchyma indicative of prior stroke) or normal. The MRI results formed the comparison standards for TCD exams in evaluating intracranial injury. Sensitivity and specificity for the two TCD criteria(TAMV and PSV) were calculated to determine which could be a better predictor for intracranial vasculopathy /clinically occult strokes.RESULTS: The study cohort for our institution was 110patients with a total of 291 TCD examinations. These patients had a mean age of 7.6 years with a range from 2-18 years of age. Sixty-two of the 110 patients(56%) had two or more TCD exams. Thirty-seven patients(34%) had at least one MRI following a TCD examination. Of the 291 TCD examinations, 46(16%) were conditional or abnormal by TAMV criteria. One hundred and sixteen(40%) were conditional
文摘BACKGROUND： Small for gestational age （SGA） has high frequency which increases the risk of long-term adverse outcomes. Thus the aim of this study was to evaluate peak systolic velocity Doppler of middle cerebral artery （MCA） in SGA fetus in order to find appropriate method to diagnosis SGA sooner. MATERIALS and METHODS： This prospective longitudinal study was conducted on 90 pregnant women with a diagnosis of SGA fetus and 90 pregnant women with normal fetus. Then MCA and umbilical artery assessment were performed for all subjects and compared between two groups. RESULTS： Doppler assessment showed that umbilical artery PI was significantly higher in SGA group as compared to normal group （1.114-0.37 vs 0.984-0.18, P = 0.003）, while MCA PI was significantly lower in SGA group （1.77±0.44 vs 1.92±0.47, P = 0.028）. On the other hand, PSV did not differ between the groups （P = 0.592）. Moreover, we found that PSV was more in SGA group by grouping maternal age （〈 27 years） （P = 0.006）, and gestational age （〉 34 weeks） （P 〈 0.001）. CONCLUSION： The results of this study suggest that MCA PI decreased significantly in SGA fetuses, while UA PI increased in this group. Moreover, PSV increased in this group when evaluated in different subgroups （based on maternal age and gestational age）.
文摘目的建立应用超声多谱勒技术测量各孕周胎儿大脑中动脉峰值血流速度(middle cerebral artery peak systolic velocity,MCV-PSV)的正常值。方法对1197例次的胎儿进行各孕周大脑中动脉峰值血流速度进行测量,计算中位数,百分位数,1.5倍中位数(multiples of the median,MOM表示)。结果胎儿大脑中动脉峰值血流速度随着孕周增加而升高。结论利用这不同孕周正常值数据,算出1.5倍中位数值作为判断胎儿宫内贫血状态的指标。
