PD4-01 FOLLOW UP OF LOWER URETERAL STONES: A PROSPECTIVE COMPARATIVE STUDY BETWEEN NON-CONTRAST COMPUTED TOMOGRAPHY AND COLOR DOPPLER ULTRASOUND

Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis. Color Doppler ultrasound demonstrated lack of vascularity within the allograft. The patient was taken urgently to the operating room where the renal allograft was found twisted 360 degrees around the vascular pedicle. After the allograft was detorsed, the color of the kidney returned and the Doppler signals for arterial flow improved. Intraoperative biopsy showed no evidence of infarct or acute cellular rejection. The detorsed kidney was surgically fixed in position in its upper and lower poles. Follow-up ultrasound 1 day later demonstrated normal blood flow to the renal allograft and the serum level of creatinine returned to normal.

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Venous leakage treatment revisited: pelvic venoablation using aethoxysclerol under air block technique and Valsalva maneuver

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2015.1.1 ◽

2015 ◽

Vol 87 (1) ◽

pp. 1 ◽

Cited By ~ 9

Author(s):

Ralf Herwig ◽

Salvatore Sansalone

Keyword(s):

Doppler Ultrasound ◽

Valsalva Maneuver ◽

Color Doppler ◽

Pde5 Inhibitor ◽

Penile Prosthesis ◽

Cost Effective ◽

Color Doppler Ultrasound ◽

Pde5 Inhibitors ◽

Venous Leakage

Objective: We evaluated the effectiveness of pelvic vein embolization with aethoxysclerol in aero-block technique for the treatment of impotence due to venous leakage in men using sildenafil for intercourse. The aim of the procedure was to reduce the use of sildenafil. Methods: A total of 96 patients with veno-occlusive dysfunction, severe enough for the need of PDE5 inhibitors for vaginal penetration, underwent pelvic venoablation with aethoxysclerol. The mean patient age was 53.5 years. Venous leaks were identified by Color Doppler Ultrasound after intracavernous alprostadil injection. Under local anesthesia a 20-gauge needle was inserted into the deep dorsal penile vein. The pelvic venogram was obtained through deep dorsal venography. Aethoxysclerol 3% as sclerosing agent was injected after air-block under Valsalva manoeuver. Success was defined as the ability to achieve vaginal insertion without the aid of any drugs, vasoactive injections, penile prosthesis, or vacuum device. Additionally, a pre- and post- therapy IIEF score and a digital overnight spontaneous erections protocol (OSEP) with the NEVA™-system was performed. Results: At 3 month follow-up 77 out of 96 patients (80.21%) reported to have erections sufficient for vaginal insertion without the use of any drug or additional device. Four (4.17%) patients did not report any improvement. Follow up with color Doppler ultrasound revealed a new or persistent venous leakage in 8 (8.33%) of the patients. No serious complications occurred. Conclusions: Our new pelvic venoablation technique using aethoxysclerol in air-block technique was effective, minimally invasive, and cost-effective. All patients were able to perform sexual intercourse without the previously used dosage of PDE5 inhibitor. This new method may help in patients with contra-indications against PDE5 inhibitors, in patients who cannot afford the frequent usage of expensive oral medication or those who do not fully respond to PDE5-inhibitors.

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Color Doppler Ultrasound versus Computed Tomography Angiography for Preoperative Anterolateral Thigh Flap Perforator Imaging: A Systematic Review and Meta-Analysis

Journal of Reconstructive Microsurgery ◽

10.1055/s-0041-1740958 ◽

2021 ◽

Author(s):

Reece Moore ◽

Donna Mullner ◽

Georgina Nichols ◽

Isis Scomacao ◽

Fernando Herrera

Keyword(s):

Computed Tomography ◽

Doppler Ultrasound ◽

Computed Tomography Angiography ◽

False Positive ◽

Color Doppler ◽

Color Doppler Ultrasound ◽

Preoperative Imaging ◽

Anterolateral Thigh Flap ◽

Anterolateral Thigh ◽

Alt Flap

Abstract Background The anterolateral thigh (ALT) perforator flap is a commonly used flap with a predictable, though often variable, perforator anatomy. Preoperative imaging with color Doppler ultrasound (CDU) and computed tomography angiography (CTA) of ALT flap perforators can be a useful tool for flap planning. This study provides a complete review and analysis of the relevant preoperative ALT imaging literature. Methods Studies related to preoperative CDU and CTA imaging were reviewed, and information related to imaging method, sensitivity, false-positive rates, and perforator course identification (musculocutaneous vs. septocutaneous) were analyzed. Results A total of 23 studies related to preoperative ALT flap CDU and CTA imaging were included for review and analysis. Intraoperative perforator identification was compared with those found preoperatively using CDU (n = 672) and CTA (n = 531). Perforator identification sensitivity for CDU was 95.3% (95% CI: 90.9–97.6%) compared with the CTA sensitivity of 90.4% (95% confidence interval [CI]: 74.4–96.9%). The false-positive rate for CDU was 2.8% (95% CI: 1.1–4.5%) compared with 2.4% (95% CI: 0.7–4.1%) for CTA. Accuracy of perforator course identification was 95.5% (95% CI: 93.6–99.2%) for CDU and 96.9% (95% CI: 92.7–100.1%) for CTA. Conclusion CDU provides the reconstructive surgeon with greater preoperative perforator imaging sensitivity compared with CTA; however, false-positive rates are marginally higher with preoperative CDU. Preoperative imaging for ALT flap design is an effective tool, and the reconstructive surgeon should consider the data presented here when selecting a flap imaging modality.

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COLOR DOPPLER ULTRASONOGRAPHY FINDINGS IN KIDNEY ALLOGRAFTS BEFORE AND AFTER TRANSPLANTATION

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i6.1210 ◽

2020 ◽

Vol 4 (6) ◽

Author(s):

Suraj Mathur ◽

P. Rajan ◽

Dr. Jaya Kumar E. K

Keyword(s):

Doppler Ultrasound ◽

Doppler Ultrasonography ◽

Color Doppler ◽

Vascular Complications ◽

Biochemical Parameter ◽

Color Doppler Ultrasound ◽

Color Doppler Ultrasonography ◽

Kidney Allograft ◽

Significant Difference

Method: A sample size of 40 kidney allograft recipients undergoing color Doppler Ultrasonography evaluation included in the study. Result: Corticomeduallry differentiation of kidney allografts within 24 hours post transplant period: There was no significant difference between CMD of kidney allorgrafts with complication and kidney allografts without any complication within 24 hour because the standard deviations of both groups were 0. Corticomeduallry differentiation in all kidney allografts, all were shows maintained corticomedullary differentiation. Conclusion: This study is aimed to assessing the role of CDUS in kidney allograft recipients to evaluate the graft perfusion immediate after anastamosis, within 24 hours and follow up period after engraftment of kidney allograft. Analyse the Color Doppler Ultrasound (CDUS) indices changes in parenchymal, and vascular cause of allograft dysfunction at follow up periods, to evaluate the uroloical, surgical and vascular complications in kidney recipients by using gray scale and color Doppler US at follow up periods and compare the results with biochemical parameter (serum creatinine). Immediate Doppler ultrasound is highly useful in the diagnosis of primary graft dysfunction and in follow-up of the transplanted patient. Keywords: Graft Perfusion, Anastamosis, Color, Doppler, Ultrasound

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Validation of color Doppler ultrasound and computed tomography in the radiologic assessment of non-malignant acute splanchnic vein thrombosis

PLoS ONE ◽

10.1371/journal.pone.0261499 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0261499

Author(s):

Lukas Sturm ◽

Dominik Bettinger ◽

Christoph Klinger ◽

Tobias Krauss ◽

Hannes Engel ◽

...

Keyword(s):

Computed Tomography ◽

Portal Vein ◽

Doppler Ultrasound ◽

Gold Standard ◽

Color Doppler ◽

Color Doppler Ultrasound ◽

Splanchnic Vein Thrombosis ◽

Vein Thrombosis ◽

Cohen's Kappa ◽

Radiologic Assessment

Introduction International guidelines propose color Doppler ultrasound (CDUS) and contrast-enhanced computed tomography (CT) as primary imaging techniques in the diagnosis of acute splanchnic vein thrombosis. However, their reliability in this context is poorly investigated. Therefore, the aim of our study was to validate CDUS and CT in the radiologic assessment of acute splanchnic vein thrombosis, using direct transjugular spleno-portography as gold standard. Materials and methods 49 patients with non-malignant acute splanchnic vein thrombosis were included in a retrospective, multicenter analysis. The thrombosis’ extent in five regions of the splanchnic venous system (right and left intrahepatic portal vein, main trunk of the portal vein, splenic vein, superior mesenteric vein) and the degree of thrombosis (patent, partial thrombosis, complete thrombosis) were assessed by portography, CDUS and CT in a blinded manner. Reliability of CDUS and CT with regard to portography as gold standard was analyzed by calculating Cohen’s kappa. Results Results of CDUS and CT were consistent with portography in 76.6% and 78.4% of examinations, respectively. Cohen’s kappa demonstrated that CDUS and CT delivered almost equally reliable results with regard to the portographic gold standard (k = 0.634 [p < 0.001] vs. k = 0.644 [p < 0.001]). In case of findings non-consistent with portography there was no clear trend to over- or underestimation of the degree of thrombosis in both CDUS (60.0% vs. 40.0%) and CT (59.5% vs. 40.5%). Conclusions CDUS and CT are equally reliable tools in the radiologic assessment of non-malignant acute splanchnic vein thrombosis.

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