scholarly journals Ultrasound Characteristics of the Nutcracker Syndrome

2018 ◽  
Vol 24 (2) ◽  
Author(s):  
Ihor Kobza ◽  
Irena Nesterenko ◽  
Volodymyr Nesterenko
Keyword(s):  
Blood Flow ◽  
Renal Vein ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Left Renal Vein ◽  
Peak Systolic Velocity ◽  
Gonadal Vein ◽  
Critical Stenosis ◽  
Vein Stenosis

The article presents the results of color Doppler ultrasonography of the left renal vein and gonadal vein with the determination of the peak systolic velocity of blood flow and abnormal blood reflux in patients with left-sided varicocele. The objective of the research was to compare preoperative ultrasound characteristics of the left renal vein, left gonadal vein, peak systolic velocity of blood flow and the presence of abnormal blood reflux, the formation of ultrasound criteria for the selection of patients for surgical correction of phlebohypertension. Results. Ultrasound signs of aorta mesenteric compression were absent in 24 (24.5%) patients; the signs of aorta mesenteric compression without critical left renal vein stenosis were observed in 64 (65.3%) patients; critical stenosis of the left renal vein was diagnosed in 10 (10.2 %) patients. The patients with critical stenosis of the left renal vein underwent left renal vein transposition. Conclusions. Ivanissevich surgery with prognostically low risk of relapse is recommended for the patients with left-sided varicocele without any signs of aorta mesenteric compression. Patients with the signs of aorta mesenteric compression require clear determination of the degree of left renal vein stenosis. We consider the transposition of the left renal vein to be indicated in case of critical stenosis when the correlation of the diameters of the distal and proximal segments of the left renal vein is ≥ 3 and the ratio of peak systolic velocities in the proximal and distal segments is ≥ 6. Thus, the diagnosis of phleborenohypertension in the patients with varicocele by means of color Doppler ultrasonography with the determination of blood flow velocity indicators in the left renal vein circulation and the determination of the critical stenosis of the left renal vein is decisive in choosing the surgical method of treatment. This provides an opportunity to evaluate the cause of varicocele occurrence and choose the optimal method of surgical treatment.  

scholarly journals TREATMENT OF AORTA MESENTERIC COMPRESSION: CURRENT PROBLEMS AND PROSPECTS

2021 ◽  
pp. 36-42
Author(s):  
I. R. Nesterenko
Keyword(s):  
Ct Angiography ◽  
Doppler Ultrasound ◽  
Renal Vein ◽  
Color Doppler ◽  
Left Renal Vein ◽  
Clinical Manifestations ◽  
Color Doppler Ultrasound ◽  
Nutcracker Syndrome ◽  
Pelvic Organs ◽  
Vein Stenosis

Left renal vein compression between the aorta and the superior mesenteric artery at an acute angle of the origin of the latter (“the nutcracker syndrome”) often leads to phlebohypertension in the left renal vein causing a combination of structural and functional changes in the kidneys and pelvic organs, different clinical manifestations such as left-sided varicocele, hematuria, pelvic venous congestion syndrome, the development of renal failure. The objective of the research: to determine indications for surgical and conservative treatment of aorta mesenteric compression. Materials and methods. The study included 210 patients (142 men and 68 women) with suspected “nutcracker syndrome” who were referred to vascular surgeons for a consultation by urologists and gynecologists during the period from 1999 to 2020, mainly from the western regions of Ukraine (about 11 million population). The age of the patients ranged from 12 to 52. All patients were interviewed for specific complaints: pain in the left lumbar region and left half of abdomen, inability to eat large amounts of food, hematuria, proteinuria, hemospermia, erectile dysfunction, left sided varicocele in men, and left sided pudendal varicosity and dysmenorrhea in women. All referred patients with suspected “nutcracker syndrome” underwent color Doppler ultrasound to determine the presence of pathological reflux in the left renal and gonadal veins by measuring peak systolic velocities in order to confirm or exclude that pathology. The patients with confirmed left renal vein stenosis underwent CT angiography. Results. According to color Doppler ultrasound, different degree of aorta mesenteric compression was confirmed in 138 (65.7%) patients (83 men and 55 women), critical left renal vein stenosis was observed in 35 of them. Two patients were diagnosed with the retroaortic left renal vein (“posterior nutcracker”). According to observations, clinical manifestations of AMC syndrome severe forms occurred in case of an increase in the diameter of the distal part of the LRV compared to its proximal segment by 3-6 times as well as in case of an increase in peak systolic velocity in the stenosed proximal segment by 6-14 times (by 8.7 times on average) compared to the left renal vein distal segment. Conclusions. Color Doppler ultrasound with determination of peak systolic velocities and diameters of the left renal and gonadal veins, pathological reflux in them must be the obligatory diagnostic stage in the patients with suspected AMC. The choice of treatment approach should be made taking into account clinical and laboratory indices, as well as the assessment of AMC severity according to instrumental data (ultrasound, CT angiography, MRA, etc.). The severity of pathomorphological changes in the pelvic organs and their consequences proves the need to eliminate phlebohypertension in the left renal and gonadal veins. LRV transposition proves its effectiveness in the remote postoperative period.

scholarly journals Diagnostic Utility of Mean Peak Systolic Velocity of Superior Thyroid Artery in Differentiating Graves’ Disease from Thyroiditis

2021 ◽  
Author(s):  
Pradosh K. Sarangi ◽  
Sasmita Parida ◽  
Swayamsidha Mangaraj ◽  
Binoy K. Mohanty ◽  
Jayashree Mohanty ◽  
...  
Keyword(s):  
Blood Flow ◽  
Sensitivity And Specificity ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Peak Systolic Velocity ◽  
Color Doppler Ultrasonography ◽  
Superior Thyroid Artery ◽  
Control Group ◽  
Graves Disease ◽  
Flow Parameters

Abstract Background Differentiating Graves’ disease from thyroiditis can be at times clinically challenging. The gold standard test (thyroid nuclear imaging scan) is expensive, not routinely available, and has radiation exposure. Color Doppler ultrasonography of thyroid represents a suitable alternate which can be used for differentiating these conditions by studying thyroid blood flow parameters. Aim We aimed to investigate the use of thyroid blood flow parameters’ assessment of the superior thyroid artery (STA) and common carotid artery (CCA) with color Doppler ultrasonography for differentiating Graves’ disease from thyroiditis. Materials and Methods This is a cross-sectional study on 111 patients with newly diagnosed thyrotoxicosis (82 with Graves’ disease and 29 with thyroiditis) and 45 years of age and sex-matched healthy controls. All patients underwent detailed clinical and necessary investigations. Color Doppler ultrasonography of the thyroid gland and spectral flow analysis of both superior thyroid arteries was done using standard protocol. Sensitivity and specificity for mean peak systolic velocity of STA (STA-PSV) cut-offs were calculated using receiver operating characteristic curves. Results Patients with Graves’ disease have significantly higher free tri-iodothyronine (FT3) levels, free thyroxine (FT4) levels, antithyroid stimulating hormone receptor antibody (TRAb) levels, and thyroid volume as compared with those with thyroiditis. The mean STA-PSV of patients with Graves’ disease was significantly higher than thyroiditis and control group. Mean STA-PSV greater than 54.3 cm/s had 82.9% sensitivity and 86.2% specificity in diagnosing Graves’ disease. Mean PSV-STA/PSV-CCA ratio of 0.40 was 80.5% sensitive and 86.2% specific for Graves’ disease. Conclusion Mean STA-PSV has high sensitivity and specificity in differentiating Graves’ disease from thyroiditis and can be used routinely in clinical practice as a cheap and invaluable diagnostic tool.

scholarly journals Determination of Testicular Blood Flow in Camelids Using Vascular Casting and Color Pulsed-Wave Doppler Ultrasonography

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Michelle Kutzler ◽  
Reid Tyson ◽  
Monica Grimes ◽  
Karen Timm
Keyword(s):  
Blood Flow ◽  
Doppler Ultrasonography ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Ventral Surface ◽  
Testicular Artery ◽  
Diastolic Velocity ◽  
Testicular Blood Flow ◽  
Pulsed Wave Doppler

We describe the vasculature of the camelid testis using plastic casting. We also use color pulsed-wave Doppler ultrasonography to measure testicular blood flow and compare the differences between testicular blood flow in fertile and infertile camelids. The testicular artery originates from the ventral surface of the aorta, gives rise to an epididymal branch, and becomes very tortuous as it approaches the testis. Within the supratesticular arteries, peak systolic velocity (PSV) was higher in fertile males compared to infertile males (P=0.0004). In addition, end diastolic velocity (EDV) within the supratesticular arteries was higher for fertile males when compared to infertile males (P=0.0325). Within the marginal arteries, PSV was also higher in fertile males compared to infertile males (P=0.0104). However, EDV within the marginal arteries was not significantly different between fertile and infertile males (P=0.121). In addition, the resistance index was not significantly different between fertile and infertile males within the supratesticular (P=0.486) and marginal arteries (P=0.144). The significance of this research is that in addition to information obtained from a complete reproductive evaluation, a male camelid's fertility can be determined using testicular blood flow measured by Doppler ultrasonography.

scholarly journals Evaluation of Orbital Blood Flow in Age-Related Macular Degeneration by Color Doppler Ultrasonography

2020 ◽  
Vol 27 (2) ◽  
pp. 177-183
Author(s):  
Mine Karahan ◽  
Deniz Kilic ◽  
Mehmet Emin Dursun ◽  
Birgül Dursun ◽  
Aslı Uğurlu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Macular Degeneration ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Color Doppler Ultrasonography ◽  
Age Related Macular Degeneration ◽  
Age Related

Anatomo-functional state of organs of small tangs in poor responders

2018 ◽  
pp. 50-54
Author(s):  
G.V. Strelko ◽  
Keyword(s):  
Blood Flow ◽  
Functional Status ◽  
Vascular Resistance ◽  
Functional State ◽  
Color Doppler ◽  
Ovarian Response ◽  
Treatment Programs ◽  
Poor Responders ◽  
Surgical Interventions

The objective: study of the anatomical and functional status of the uterus and ovaries in poor responders in ART programs. Materials and methods. Determination of the anatomical features and functional status of the uterus and ovaries in «poor responders» to exclude a clinically significant pathology that would affect the success of the ART program was performed by ultrasound scanning with the study of topografts, sizes, contours, echostructure of the uterus and ovary and determination of the volume of the ovaries and the number of antral follicles. Blood flow in the vessels of the stroma of the ovaries, as one of the important criteria for assessing the possible ovarian response, was assessed using color Doppler mapping. Results. «Poor responders» patients have a smaller sise of ovaries and a reduced number of antral folicles, which can be explained by the surgical interventions carried out according to the type of ovarian resection and the cysts removal. In addition, during the transition from the follicular to luteal phase, there is no decrease in the vascular resistance of the dominant follicle, which slows the process of ovulation and reduces the likelihood of fertilization in conditions of increased vascular resistance. Conclusion. Ultrasound examination of the uterus and ovaries and doplerometric investigation of peryfollicular blood flow allows us to thoroughly approach both the evaluation of the ovarian response and the endometric readiness for implantation, which dictates the need for an individual selection of preconceptional preparation and treatment programs for ART. Key words: anatomical and functional state, pelvic organs, ovarian reserve, peryfollicular blood flow, poor responders.

EP980 Gonadal vein graft after retroaortic left renal vein injury during paraaortic lymphadenectomy: a case report

2019 ◽  
Author(s):  
S Seyfettinoglu ◽  
G Khatib ◽  
U Kucukgoz Gulec ◽  
AB Guzel ◽  
Y Bayazit ◽  
...  
Keyword(s):  
Case Report ◽  
Vein Graft ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Gonadal Vein ◽  
Paraaortic Lymphadenectomy ◽  
Vein Injury

scholarly journals 298 Effects of parity on late gestational uterine blood flow and hemodynamics in beef cattle

2019 ◽  
Vol 97 (Supplement_3) ◽  
pp. 137-138
Author(s):  
Allison M Meyer ◽  
Natalie B Duncan ◽  
Katy S Stoecklein ◽  
Emma L Stephenson
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Birth Weight ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Color Doppler ◽  
Peak Systolic Velocity ◽  
Late Gestation ◽  
Artery Blood Flow ◽  
Diastolic Velocity

Abstract To determine parity effects on late gestational uteroplacental blood flow, uterine artery hemodynamics were measured in 13 primiparous and 11 multiparous (parity 3 and 4) non-lactating, fall-calving crossbred females beginning 109 d prepartum. Females were nutritionally managed as one group to meet or exceed nutrient requirements. Transrectal color Doppler ultrasonography of the both uterine arteries was conducted 3 to 6 times per female across late gestation, ending at approximately 20 d prepartum. Data were analyzed with parity (primiparous vs. multiparous), day prior to calving, and their interaction in the model; day was a repeated effect. Dam BW was greater (P < 0.001) for multiparous than primiparous females, and increased (P = 0.004) as gestation progressed. Calf birth weight was unaffected (P = 0.87) by parity. The parity x day interaction tended to affect (P = 0.06) ipsilateral uterine artery blood flow (L/min), where multiparous cows had a greater increase per day. Total and contralateral uterine artery blood flow were unaffected (P ≥ 0.11) by parity, but increased (P < 0.001) with day of gestation. When expressed relative to dam BW, total and contralateral blood flow were greater (P ≤ 0.04) in primiparous than multiparous females; ipsilateral blood flow was unaffected (P ≥ 0.13) by parity, however. Ipsilateral pulsatility index and both resistance indices were unaffected (P ≥ 0.28) by parity and day, but day tended to affect (P = 0.07) contralateral pulsatility index. Parity did not affect (P ≥ 0.11) cross-sectional area, mean velocity, peak systolic velocity, and end diastolic velocity of either uterine artery, but all increased (P < 0.001) as gestation progressed. Heart rate was greater (P = 0.03) in primiparous than multiparous females. Data suggest that uterine artery blood flow and heart rate may be altered in primiparous females, even when birth weight is unaffected by parity.

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