Assessment of optic nerve vascularity in healthy eyes using superb microvascular imaging: a preliminary study

2021 ◽  
pp. 028418512098327
Author(s):  
Abdussamet Batur ◽  
Muhammed Alpaslan ◽  
Sercan Özkaçmaz ◽  
M Sedat Durmaz

Background Changes in optic nerve vascularity are observed in many diseases. Superb microvascular imaging (SMI) has the potential to become the method of choice for detecting microvasculature in the optic nerves. Purpose To evaluate optic nerve vascularity in healthy individuals through power Doppler sonography (PDUS) and SMI. Material and Methods Twenty-seven healthy patients with 54 eyes were prospectively evaluated. The duration of the examination for optic nerve vascularity lasted until the posterior ciliary artery blood supply was observed in PDUS and SMI. The visibility of vascularity, as well as the ratio of the vascular structures to the optic nerves (vascular index [VI]), was evaluated. Results Fifty-four eyes were evaluated from a total of 27 patients (mean age = 49.0 ± 19.42 years). The VI value for the right optic nerve was 29.58 ± 4.00 while for the left optic nerve, it was 31.21 ± 3.52. Vascularity was clearly observed in both eyes (n = 54) in all 27 cases in the evaluation performed with the SMI technique. However, with the power Doppler examination, vascular flow was not observed in 14 right eyes and in 10 left eyes within the specified timeframe. Conclusion The results indicate that imaging of vascular structures can be done faster and better with SMI than PDUS examination. The normal VI values may provide important information about the blood supply of the optic nerve, which is of relevance in orbital pathologies and many systemic conditions.

2017 ◽  
Vol 7 ◽  
pp. 45 ◽  
Author(s):  
Suheil Artul ◽  
William Nseir ◽  
Zaher Armaly ◽  
Michalle Soudack

Determining the presence and characteristics of vascular flow is an essential part of sonography interrogation. However, small vessels and low velocities are not always possible to depict with conventional color and power Doppler ultrasound. This can be frustrating, especially when the diagnosis depends mainly on the existence of vascular flow, the sonographic examination will be inconclusive, further imaging examinations will be required and diagnosis delayed. Superb microvascular imaging (SMI) is a novel vascular imaging mode, which provides visualization of low velocity and microvascular flow. SMI uses a clutter suppression algorithm to extract flow signals and depicts this information as a color overlay image or as a monochrome or color map of flow. By using SMI, high frame rates and high-resolution images remain maintained. With SMI, it is possible to visualize small vessels including their branches that, until now, it is possible to demonstrate only using contrast-enhanced ultrasound. Availability of this additional technology on all ultrasound machines may make some of the computed tomography scans unnecessary. In our paper, we describe six patients, aged 16–73 years, in which final diagnosis was achieved only with SMI and where conventional color and power Doppler failed. All these examinations were performed using Aplio 500 Platinum ultrasound unit (Toshiba Medical Systems, Tokyo, Japan).


2021 ◽  
Vol 3 (1) ◽  
pp. 22-24
Author(s):  
Fatih Ateş ◽  
Halil İbrahim Sara ◽  
Mehmet Sedat Durmaz

In this case we aimed to present use of superb microvascular imaging (SMI) in the discrimination of fetal intracranial mass- haemorrhage with the light of literature. 21 weeks pregnancy woman applied to the clinic for routine obstetrics control. Ultrasonography (US) was applied to the patient. In the gray scale US, intracranial midline a large mass was detected. In the colour doppler (CD), the blood flow (BF) to the mass was not clearly seem. Power doppler (PD) was very artifact. In color SMI (cSMI) and monochrome SMI (mSMI), blood flow (BF) of the mass was seem clearly and fetal intracranial mass was prediagnosed. Magnetic Resonance imaging (MRI) was performed to determine the location of the mass, brain parenchyma and origin of the mass. Intracranial midline a large mass was detected in fetal MRI too. Although there are cases in the literature regarding the use of SMI in obstetrics, there is no case report in which fetal intracranial mass was evaluated by SMI to our knowledge. In our case; we have detected fetal intracranial mass by gray scale US, and we have evaluated vascularization of the mass by CD, PD, cSMI and mSMI. SMI modes were showing superiority when compared to CD and PD. Vascularization could be seen more clearly by mSMI when compared to cSMI.


2021 ◽  
Vol 14 (2) ◽  
pp. e239112
Author(s):  
Julian Alejandro Santos ◽  
Cherica Afurong Tee ◽  
Romelito Jose Galvan Galsim ◽  
Michael Lucas Tee

A 60-year-old woman with rheumatoid arthritis consulted for acute flare. She had elevated disease activity score 28 - erythrocyte sedimentation rate (DAS 28-ESR) of 6.88 and clinical disease activity index (CDAI) of 32. Her 12-joint ultrasound revealed widespread joint effusion. Synovial vascularity scores measured through superb microvascular imaging (SMI) and power Doppler were universally increased. We documented her treatment response 2 weeks after she received a single dose of biosimilar infliximab using clinical and sonographic data. Her DAS 28-ESR and CDAI scores decreased to 4.21 and 7.0, respectively. Reduction in synovial vascularity scores was demonstrated using SMI. While there was near total resolution in joint effusion and tenosynovitis, SMI was able to demonstrate synovial vascularity in joints with no clinical swelling nor tenderness. Musculoskeletal ultrasound and superb microvascular imaging are useful adjuncts in evaluating synovitis in rheumatoid arthritis and documenting treatment response through documentation of synovial vascularity, effusion and tenosynovitis.


2021 ◽  
Vol 1 (2) ◽  
pp. 26-31
Author(s):  
Muhammad O. Awiwi ◽  
◽  
Omer Bagcilar ◽  
Migena Gjoni ◽  
Serkan Akbas ◽  
...  

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