Diagnostic value of 3D power Doppler ultrasound in the characterization of thyroid nodules

Background/aim: To evaluate the diagnostic value of vascular indices obtained using 3D power Doppler ultrasound (3DPDUS) in differentiation of benign and malignant thyroid nodules. Materials and methods: Sixty-seven patients (56 female, 11 male, mean age 44.6) with 81 thyroid nodules exhibiting mixed (peripheral and central) vascularization patterns and with the largest diameter of between 10 mm and 30 mm were prospectively evaluated using 3DPDUS. Nodule volume, vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were calculated using Virtual Organ Computer-aided Analysis (VOCAL) software, and these indices were then compared with regard to the cyto-histopathology-based diagnosis. The optimum cutoff values for the differentiation of benign and malignant nodules were identified, and diagnostic efficacy was calculated using receiver operating characteristic (ROC) analysis. Results: Fifty-six of the 81 nodules included in this study were diagnosed as benign and 25 as malignant. Vascular indices in malignant nodules were significantly higher than those in benign nodules (p<0.05). In benign nodules, mean VI was 11.61 ± 6.88, mean FI was 39.75 ± 3.93 and VFI was 4.82 ± 2.94, compared to 18.64 ± 12.81, 41.82 ± 4.43 and 8.17 ± 6.37, respectively, in malignant nodules. The area under the curves (AUCs) were calculated as 0.68, 0.61 and 0.67 for VI, FI and VFI, respectively. At optimal cut-off values of 10.2 for VI, 40.8 for FI and 5.5 for VFI, sensitivity and specificity were 72%/55.4%, 68%/57.1% and 68%/67.9%, respectively. Conclusion: 3DPDUS could be useful in the characterization of thyroid nodules. Key words: Thyroid nodules; three-dimensional power Doppler ultrasound; vascular indices; VOCAL

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Three-Dimensional Power Doppler Analysis of Cerebral Circulation in Normal and Growth-Restricted Fetuses

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.2009.70 ◽

2009 ◽

Vol 29 (9) ◽

pp. 1609-1618 ◽

Cited By ~ 17

Author(s):

Jose L Bartha ◽

Eva M Moya ◽

Blas Hervías-Vivancos

Keyword(s):

Doppler Ultrasound ◽

Cerebral Circulation ◽

Pulsatility Index ◽

Power Doppler ◽

Three Dimensional ◽

Flow Index ◽

Power Doppler Ultrasound ◽

3D Power Doppler ◽

Doppler Indices ◽

Vascularization Index

The objective of the present study was to evaluate fetal cerebral circulation by using three-dimensional (3D) power Doppler ultrasound in normal and growth-restricted fetuses. A total of 100 normal grown fetuses were compared with other 25 with growth restriction (FGR). Three-dimensional power Doppler ultrasound was used to assess fetal cerebral 3D vascular indices: vascularization index, flow index (FI), and vascularization flow index (VFI). Both FI and VFI correlated positively with gestational age. On average, all the 3D vascular indices were increased in fetuses with FGR. The proportion of fetuses detected as having hemodynamic redistribution was higher when using 3D power Doppler indices than by means of the middle cerebral artery pulsatility index (52% versus 20%, P = 0.002). In conclusion, two of the three indices increased during gestation. All the fetal cerebral 3D vascular indices are increased in fetuses with FGR. In these fetuses, there were more cases suggesting hemodynamic redistribution than expected by conventional Doppler studies.

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Difference between Vascularization Indexes of the Placenta in Severe Pre-eclampsia and Normal Pregnancy by Three-dimensional Power Doppler Ultrasound

Donald School Journal of Ultrasound in Obstetrics & Gynecology ◽

10.5005/jp-journals-10009-1372 ◽

2014 ◽

Vol 8 (4) ◽

pp. 329-335 ◽

Cited By ~ 1

Author(s):

Wiku Andonotopo ◽

Herman Kristanto ◽

Julian Dewantiningrum ◽

Besari Adi Pramono

Keyword(s):

Pregnant Women ◽

Doppler Ultrasound ◽

Gestational Age ◽

Power Doppler ◽

Three Dimensional ◽

Normal Pregnancy ◽

Flow Index ◽

Control Group ◽

Power Doppler Ultrasound ◽

3D Power Doppler

ABSTRACT Aim The object of this study was to analyze the vascularization index of three-dimensional (3D) power Doppler ultrasound (PDUS) of the placenta in severe pre-eclampsia compared with normal pregnancy conditions by vascular biopsy sampling sphere. Subjects and methods This study is a prospective longitudinal observational study on 80 pregnant women which divided into 2 groups: Group I (study group) were 40 pregnant women with severe pre-eclampsia, group II (control group) were 40 pregnant women without disorder. Variables examined in this study were vascular index (VI), flow index (FI) and vascular flow index (VFI) of the 3D-PD placental perfusion. Its correlation to gestational age in normal pregnancy compared with the condition of preeclampsia were obtained by taking multiple biopsy sampling vascular sphere. All pregnant women underwent 3D PD-US examination (single examination only), data volume recorded of the placenta allows for off-line analysis without the presence of the patient, thus allowing the data analysis done anywhere and anytime by observers for the comparative analysis of interobserver reliability. Results The placenta can be visualized perfectly in both of the study group and also the control group. Average Kappa value for the acquisition of placental vascularization index measurements with 3D PD-US was 0.72 (0.61-0.82), 0.73 (0.65-0.82) and 0.71 (0.61-0.81) for VI, FI and VFI in the range of 20 to 38 weeks showed good interobserver reliability. All 3D power Doppler indices had a significant association with gestational age, with VI showed a less significant relationship (r = 0.207, p = 0.0139) and FI has the most significant relationship (r = 0.582, p < 0.001). FI index increased progressively with gestational age, while the VI index values indicate dispersion pattern and reached a plateau from week 30 onwards. Entering week 37th, there was a decrease in the value of the index VI until the end of pregnancy. Meanwhile, VFI index appears to resemble the pattern of a combination of both VI and FI index (r = 0.692, p <0.001). Conclusion All parameters of 3D power Doppler index was lower in the severe pre-eclampsia compared with normal pregnancy. 3D PD-US can be used to assess the vascularization of the placenta and the intensity of intra-placental blood flow. Placental vascular biopsy method is fairly efficient way to perform routine evaluations evolution of placental vascular branch during pregnancy. How to cite this article Andonotopo W, Kristanto H, Dewantiningrum J, Pramono BA. Difference between Vascularization Indexes of the Placenta in Severe Pre-eclampsia and Normal Pregnancy by Three-dimensional Power Doppler Ultrasound. Donald School J Ultrasound Obstet Gynecol 2014;8(4):329-335.

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