Intraoperative Doppler to Measure Cerebrovascular Resistance as a Guide to Complete Resection of Arteriovenous Malformations

Neurosurgery ◽  
2004 ◽  
Vol 55 (1) ◽  
pp. 155-161 ◽  
Author(s):  
Robert J. Dempsey ◽  
Roham Moftakhar ◽  
Myron Pozniak
Keyword(s):  
Arteriovenous Malformations ◽  
Color Doppler ◽  
Resistive Index ◽  
Color Doppler Ultrasound ◽  
Complete Resection ◽  
Cerebrovascular Resistance ◽  
Accurate Localization ◽  
Spectral Doppler ◽  
The Mean ◽  
Duplex Doppler

Abstract OBJECTIVE: Intraoperative color Doppler ultrasound has been used to locate arteriovenous malformations (AVMs). We describe the use of spectral Doppler to measure flow resistance and resistive index (RI) of vessels around the nidus to distinguish feeding arteries from en passant and normal vessels. This is particularly helpful in small AVMs and aids in the identification of normal vessels and completeness of resection by ruling out persistent low RI flow. METHODS: Seven patients with AVMs underwent resection. Spectral Doppler applied to the vessels in proximity to the AVM, along with calculated RI, was used to identify feeding arteries and draining veins. After presumed surgical resection of the AVM, pre-resection and postresection RIs were compared to identify residual AVM. Postoperative angiography was performed in all seven patients to confirm complete resection of the AVM. RESULTS: The mean pre-resection RI of vessels feeding the AVM was 0.34 (±0.01). In five patients without residual nidus on the basis of postresection color Doppler and postoperative angiogram, the postresection RI was 0.62 (±0.04). In two patients, the postresection scan identified a nidus with persistent low RI flow. Once residual AVM was resected, the RI became significantly higher. A postoperative angiogram confirmed complete resection of the AVM in all patients. CONCLUSION: Intraoperative duplex Doppler allowed more accurate localization of the AVM nidus. RI of the vessels around the AVM helped to distinguish vessels feeding the AVM from en passant vessels. Furthermore, comparison of pre-resection and postresection RI accurately indicated the completeness of resection.

scholarly journals Color Doppler Evaluation of Arterial Resistive Index in Infantile Hemangioma: A Useful Parameter to Monitor the Response to Oral Propranolol?

2021 ◽  
Vol 9 ◽  
Author(s):  
George Koshy Parapatt ◽  
Teresa Oranges ◽  
Guglielmo Paolantonio ◽  
Lucilla Ravà ◽  
Simona Giancristoforo ◽  
...  
Keyword(s):  
Color Doppler ◽  
Resistive Index ◽  
Color Doppler Imaging ◽  
Infantile Hemangioma ◽  
Vascular Tumor ◽  
Color Doppler Ultrasound ◽  
Doppler Imaging ◽  
Treatment Control ◽  
The Mean ◽  
Oral Propranolol

Infantile hemangioma (IH) is the most common benign vascular tumor in childhood. In more than 85% of all cases, IHs undergo spontaneous involution, but nearly 10–12% of IHs develop complications and require immediate therapy. Oral propranolol is currently the first-line treatment for IHs. Color Doppler ultrasound is the gold standard in the diagnosis of deep IH, and it is used to evaluate the morphological change and the modification of vascularization that occur during its evolution and treatment. To date, only few data in the literature described the changes of intralesional arterial resistive index (RI) during treatment with propranolol; particularly, some authors have shown an increase of intralesional arterial RI in IHs with clinical regression during treatment with propranolol. The objective of this paper is to evaluate the changes of RI of the intralesional arteries of the IHs during the treatment with oral propranolol. We retrospectively analyzed a total of 64 IHs in 60 patients treated with oral propranolol with a good clinical response. Gray-scale ultrasonography and color Doppler imaging were performed before and during the therapy. The intralesional RIs were measured before and during the treatment. For each lesion, we recorded the RI values, and then we calculated the mean RI value for any single lesion. We compared the mean RI value observed at the baseline with the mean RI value of the last detectable sampling at color Doppler. We also compared between them the mean RI values observed during intermediate ultrasound. The RI values were compared in 44 lesions, with at least two significant samplings of RI. In the 44 lesions compared, we did not find statistically significant variations in the mean RI values between the baseline control and the values recorded at the last post-treatment control. The time trend of mean RI values of the intermediate color Doppler analysis performed between the first pre-treatment control and the last measurable control did not show any statistically significant variation in the trend of mean RI values. Contrarily to what has been described by some authors, in our experience, we have not observed an increase of RI in IHs treated with oral propranolol.

scholarly journals Resistive Index of Intrarenal Artery in Evaluation of Diabetic Nephropathy

2016 ◽  
Vol 41 (3) ◽  
pp. 125-130
Author(s):  
Mahbuba Shirin ◽  
Mofazzal Sharif ◽  
Ayeshna Gurung ◽  
Anindita Datta
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Renal Dysfunction ◽  
Doppler Ultrasonography ◽  
Resistive Index ◽  
Diabetic Patients ◽  
Type I ◽  
The Mean ◽  
Duplex Doppler

Diabetes mellitus is one of the systemic diseases affecting the kidneys. Diabetic nephropathy is a serious microvascular complication of diabetes mellitus. It is the most important cause of death in type I diabetic patients, of whom 30%-40% eventually develop end-stage renal failure and 40% of type II diabetics are at risk of developing diabetic nephropathy. So, diagnosis of diabetic nephropathy is paramount for the survivability of the diabetic patients not only because of the consequences of renal progression but also because of the strong association with the risk of developing cardiovascular disease. A total number of 53 subjects were enrolled in this present cross sectional study in the department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration of Nephrology and Medicine of the same institution during two years (2011-13) aim to evaluate the diagnostic usefulness of renal resistive index (RI) by duplex Doppler ultrasonography for detection of renal dysfunction in diabetic patients. Clinically diagnosed diabetic patients having diabetic nephropathy referred to the department of Radiology and Imaging in BSMMU for ultrasonography of Kidneys, Ureters and Bladder (KUB) region or whole abdomen were selected as sample. Biochemical reports (Serum creatinine and Urinary albumin) and the RI value of intrarenal artery were correlated and analyzed. Only those patients biochemically were diagnosed as having diabetic nephropathy was included. Those with incomplete data, hydro nephrosis and renal calculus were excluded. Both the kidneys were visualized by commercially available real time scanner (GE Voluson) equipped with a curvilinear transducer operating at 3.5 MHz First Gray scale ultrasonography was done followed by Color Doppler of intra renal artery and then RI was measured. Majority (45.3%) patients were in 6th decade with the mean age was of 52.66±7.4 years and ranging from 38 to 65 years in patients. Male was found to be 54.7% of diabetic patients with male to female ratio 1.2:1. Resistive index of (? 0.7) was found in 73.6% patients with diabetes with the mean resistive index of 0.71±0.04. Positive correction between resistive index with serum creatinine (r=0.581, p<0.01) and albuminuria (r=0.725, p<0.01) were observed. It can be concluded that Resistive Index measured by duplex Doppler ultrasonography is useful diagnostic modality for detection of renal dysfunction in diabetic nephropathy patients. Resistive Index has value in identifying diabetic patients who are developing nephropathy and can be used as an additional diagnostic tool. Also it is well correlated with Serum Creatinine and Albuminuria which are the biochemical parameters to diagnose diabetic nephropathy.

NUO 2507 Color-doppler ultrasound of the prostate: assessment of the resistive index (RI)

1997 ◽  
Vol 23 ◽  
pp. S59
Author(s):  
Gernot Helweg ◽  
Ferdinand Frauscher ◽  
Peter Sögner ◽  
Hannes Strasser ◽  
Dieter zur Nedden ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Color Doppler ◽  
Resistive Index ◽  
Color Doppler Ultrasound

Portal and splanchnic haemodynamics in patients with advanced post-hepatitic cirrhosis and in healthy adults

1998 ◽  
Vol 39 (2) ◽  
pp. 152-156
Author(s):  
H. Dinç ◽  
A. Sari ◽  
H. Resit Gümele ◽  
N. Cihanyurdu ◽  
A. Baki
Keyword(s):  
Blood Flow ◽  
Portal Vein ◽  
Venous Blood ◽  
Resistive Index ◽  
Venous Blood Flow ◽  
Blood Flows ◽  
Portal Venous Blood Flow ◽  
Portal Venous Blood ◽  
The Mean ◽  
Duplex Doppler

Purpose: to assess portal and splanchnic haemodynamics, and splanchnic vascular resistance in patients with advanced post-hepatitic cirrhosis and in healthy volunteers, by means of duplex Doppler ultrasound (US) Material and Methods: the duplex Doppler US examination was performed in 16 patients with cirrhosis and in 24 healthy volunteers. We investigated vessel diameters, mean flow velocities, and mean blood flows in the portal vein, the superior mesenteric artery (SMA), and the splenic artery (SA), and measured the resistive index values of SMA and SA Results: the mean portal venous blood flow in patients with cirrhosis (829 ± 264 ml/min) was not statistically different from those in the volunteers (734 ± 194 ml/min). the ratio of the SMA and SA blood flows (621 ml/min) to the portal venous blood flow (734 ml/min) was 0.85 in the control subjects. the mean portal venous blood flow (1261 ml/min) and the portal venous velocity (14.6 cm/s) were higher in the patients with recanalized para-umbilical veins than in the volunteers and in the patients without recanalized para-umbilical veins. the SMA and SA blood flows were significantly increased in patients with cirrhosis compared with volunteers. Splanchnic inflow (the sum of the SMA and SA blood flows) was higher than the portal blood flow in patients with cirrhosis except in the subjects with recanalized para-umbilical veins. SMA and SA resistive index values were significantly higher in these patients than in the volunteers Conclusion: Splanchnic blood flow and splanchnic vascular impedance increased significantly in patients with advanced post-hepatitic cirrhosis. Splanchnic inflow must not exceed portal venous blood flow in patients with recanalized para-umbilical veins. Portal vein velocity and portal venous blood flow measurements alone are not useful parameters for discriminating patients with cirrhosis from healthy subjects

scholarly journals Renal transplant complications, role of resistive index on Color Doppler ultrasound

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Afshan Qureshi ◽  
Sadaf Batool ◽  
Asim Shaukat ◽  
Tahir Qadeer Khan ◽  
Khawaja Khurshid Ahmad ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Color Doppler ◽  
Resistive Index ◽  
Color Doppler Ultrasound ◽  
Renal Vein Thrombosis ◽  
Vein Thrombosis ◽  
Hydronephrotic Kidney ◽  
Transplant Complications ◽  
Transplant Procedure

We evaluated 50 patients who had renal transplants and were sent for Doppler Ultrasound for complications, after the transplant procedure. Ages of the patients ranged from 20 to 65 years, 39 were male and 11 were female. In inclusions only first month post op patients were included and only those patients were considered who had some sort of complications on ultrasound at some stage of the follow up.Following complications were noticed: Diminished corticomedullary demarcations, increased echogenicity with raised R I (20 pt). Perinephric collections other than haematoma (13 pt). Perinephric haematoma (06 pt). Obstructed transplanted kidney ( 05 pt). Diminished arterial vascularity of the kidney (04 pt) Renal vein thrombosis (02 pt). RI was found to be raised in increased echogenicity, obstructed hydronephrotic kidney, diminished arterial supply and was disturbed in RVT.

scholarly journals Doppler evaluation of breast solid masses differentiation of benign and malignant masses role of resistive index

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Sadaf Batool ◽  
Asim Shaukat ◽  
Zafarul Ahsan Saima Batool ◽  
Ayesha Siddiqa ◽  
Qureshi A ◽  
...  
Keyword(s):  
Doppler Sonography ◽  
Power Doppler ◽  
Resistive Index ◽  
Breast Masses ◽  
Spectral Doppler ◽  
Malignant Lesions ◽  
Duplex Doppler ◽  
Doppler Evaluation ◽  
Histopathological Results

Objective: To know the usefulness of color and spectral doppler in evaluation of solid breast masses using vascularity and resistive index. Material and methods: We performed duplex doppler sonography on 100 patients presenting with breast mass. Resistive index and vascularity of the vessels were detected and analyzed and correlated with histopathological results. Results: 70% of the benign lesions were found having ri below 0.8 and 45 out of 50 patients had low vascularity.43 malignant lesions had high vascularity and 80% had ri above 0.8. Conclusion: High flow visualization on power doppler and indicates a higher possibility of malignancy lesions with ri greater than 0.8 gives high probability of malignancy.

scholarly journals Effect of Magnesium Sulfate on Doppler Parameters of Fetal Umbilical and Middle Cerebral Arteries in Women with Severe Preeclampsia

2012 ◽  
Vol 2 ◽  
pp. 85 ◽  
Author(s):  
Nazanin Farshchian ◽  
Negin Rezavand ◽  
Saeed Mohammadi
Keyword(s):  
Magnesium Sulfate ◽  
Doppler Ultrasound ◽  
Color Doppler ◽  
Cerebral Arteries ◽  
Color Doppler Ultrasound ◽  
Severe Preeclampsia ◽  
Resistivity Index ◽  
Middle Cerebral Arteries ◽  
Before And After ◽  
The Mean

Objective: To assess the effect of injecting magnesium sulfate on Doppler parameters of fetal umbilical and middle cerebral arteries (MCA) in women with severe preeclampsia. Materials and Methods: A total of 21 patients with severe preeclampsia admitted to Imam Reza Hospital, Kermanshah (Iran), were evaluated. Before and after administration of magnesium sulfate, Doppler ultrasound scan was carried out to measure fetal middle cerebral artery and umbilical artery blood flow. Paired t-test was used for statistical analysis. Results: After injection of magnesium sulfate, the mean resistivity index (RI)-umbilical, and pulsatility index (PI)-cerebral showed a statistically significant reduction (P < 0.001). The cerebroumbilical C/U ratio increased after the intervention (P < 0.001). The PI-umbilical (P = 0.1) and pre- and post-RI-cerebral (P = 0.96) did not have statistically significant changes. Conclusions: Infusion of magnesium sulfate significantly decreases the flow in the fetus RI-umbilical and PI-MCA, and it increases C/U ratio indices in color Doppler ultrasound.

scholarly journals Transcranial duplex doppler ultrasonography in dogs with hydrocephalus

2010 ◽  
Vol 62 (1) ◽  
pp. 57-63 ◽  
Author(s):  
C.F. Carvalho ◽  
M.C. Chammas ◽  
J.P. Andrade Neto ◽  
C.D. Jimenez ◽  
S.A. Diniz ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Cerebral Arteries ◽  
Resistive Index ◽  
Logistic Regression Models ◽  
Neurological Signs ◽  
Duplex Doppler Ultrasound ◽  
Hemodynamic Assessment ◽  
Significant Difference ◽  
The Mean ◽  
Duplex Doppler

Transcranial duplex Doppler ultrasound was performed in 32 conscious dogs presenting ventriculomegaly detected in B-mode, obtaining measures of lateral ventricles and resistance parameters of main cerebral arteries before and after 30 days of clinical treatment. The animals were distributed divided in two groups: group 1, dogs that presented remission or decrease of the neurological signs of the disease after clinical therapy; and group 2, dogs that displayed worsening of the neurological signs or clinical stability. The data were all presented in tables and were submitted to paired t test and to logistic regression models to evaluate the influence of the RI reduction on both groups. There was no significant influence of the variables in the B-mode. After the treatment, the mean resistive index (RI) was significantly lower for the group that presented clinical improvement. There was no significant difference of the mean RI reduction for the same artery when the right and left sides were compared. It could be concluded that transcranial duplex Doppler ultrasound is a method of cerebral hemodynamic assessment able to monitor more precisely the treatment of hydrocephalus in dogs and verify the responses.

Color Doppler Ultrasound in Renal Transplant: Role of Resistive Index versus Renal Cortical Ratio in the Evaluation of Renal Transplant Diseases

2004 ◽  
Vol 98 (3) ◽  
pp. c67-c72 ◽  
Author(s):  
Francesco M. Drudi ◽  
Renzo Pretagostini ◽  
Simona Padula ◽  
Massimo Donnetti ◽  
Francesco Giovagnorio ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Doppler Ultrasound ◽  
Color Doppler ◽  
Resistive Index ◽  
Color Doppler Ultrasound

Review Article. Doppler examination of the allografted kidney

2003 ◽  
Vol 44 (1) ◽  
pp. 3-12 ◽  
Author(s):  
J. Å. Jakobsen ◽  
K. Brabrand ◽  
T. S. Egge ◽  
A. Hartmann
Keyword(s):  
Ultrasound Examination ◽  
Color Doppler ◽  
Power Doppler ◽  
Clinical Information ◽  
Review Article ◽  
Doppler Examination ◽  
Doppler Waveform ◽  
Spectral Doppler ◽  
Duplex Doppler ◽  
Doppler Color

A comprehensive ultrasound examination of the transplanted kidney includes a Doppler examination. Duplex Doppler, color Doppler and power Doppler can all reveal important information. In addition, calculation of the resistance and pulsatility indices to quantify changes in the spectral Doppler waveform can be of great help, particularly in the first weeks and months following a transplantation. The Doppler part of the examination should evaluate the vessels to and from the transplant, as well as the parenchyma with calculations of indices to detect the presence of increased vascular resistance. The conclusions drawn from the Doppler-derived information combined with the results from gray-scale scanning and clinical information will very often be of clinical significance for the handling of the patient.

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