The cut-off values for the intima–media complex thickness assessed by colour Doppler sonography in seven cranial and aortic arch arteries

Objectives Colour Doppler sonography (CDS) is becoming ever more important in the diagnosis of GCA. Data on cut-off values for intima–media complex thickness (IMT) that can be used in clinical practice to distinguish between normal and inflamed arteries are limited. We aimed to derive potential cut-off values for IMT of seven preselected arteries by comparing IMT between GCA patients and a control group. Methods We performed CDS of the preselected temporal, facial, occipital, carotid, vertebral, subclavian and axillary arteries in consecutive newly diagnosed GCA patients between October 2013 and September 2019. A ‘halo’ with positive compression sign was considered a positive finding. We measured the maximum IMT in the preselected arteries and compared it with the maximum IMT of the control group. Results We were able to demonstrate a halo sign in at least one of the examined arteries of 244/248 (98.4%) GCA patients. Temporal arteries were the most commonly affected vessels, involved in 192 (77.4%) patients. We found extracranial large vessel involvement in 87 (35.1%) patients. The following cut-off values showed high levels of diagnostic accuracy: ≥0.4 mm for temporal, facial and occipital arteries, ≥0.7 mm for vertebral arteries, and ≥1 mm for carotid, subclavian and axillary arteries. Conclusion The involvement of a large array of arteries is easily and commonly detected by CDS and provides a high diagnostic yield in patients with suspected GCA. Proposed IMT cut-off values might further improve the diagnostic utility of CDS in these patients.

194 Usefulness of the Ultrasound Imaging Modalities B-Mode and Colour Doppler Sonography and Serum Progesterone Concentrations for Determining Superovulatory Ovarian Responses in Ewes

The main goal of this study was to assess the usefulness of the 2 imaging modalities—B-mode and colour Doppler sonography—for determining the superovulatory response in ewes. In addition, serum concentrations of progesterone (P4) were examined for correlations with the numbers of laparoscopically detected luteal structures. Oestrus was synchronized in 24 sexually mature Santa Inês ewes with intravaginal P4-releasing devices (CIDR®) inserted for 8 days on a random day of the oestrous cycle. An injection of 37.5 μg of prostaglandin F2α analogue (d-cloprostenol) was given at the time of CIDR® insertion and withdrawal. The superovulatory treatment consisting of 8 consecutive doses of porcine FSH (total dose of 200 or 133 or 100 mg of pFSH; n = 8/total dose) given at 12-h intervals began 48 h before CIDR® removal. All animals received a single injection of 300 IU of eCG concurrently with a first dose of pFSH. On the day of surgical embryo recovery (6 days after the onset of behavioural oestrus), the ovaries of all donor ewes were visualised and examined with transrectal ultrasonography and then with videoendoscopy to identify and enumerate corpora lutea (CL) and luteinized unovulated follicles (LUF). Jugular blood samples were collected just before ovarian imaging for the measurement of circulating P4 concentrations. Ovaries could be easily and repeatedly detected with both the transrectal ultrasonography and videoendoscopic technique. Prematurely regressing CL could not be distinguished from healthy CL using either B-mode or colour Doppler ultrasonography but they were identified by their pale color by using videoendoscopy. All animals responded to the superovulatory treatment and produced ≥4 CL; however, a wide variation in ovarian responses was observed among ewes (range: 4–24 CL/ewe). Three ewes failed to produce healthy CL and had prematurely regressing CL only. In general, LUF were observed in 20/24 ewes (1–5/ewe) and 14/24 ewes had regressing CL (1–22/ewe). The total number of CL (r = 0.78 and 0.83; P < 0.0001) and LUF (r = 0.74 and 0.90; P < 0.0001) enumerated using the B-mode and colour Doppler ultrasonographic technique, respectively, were correlated with that ascertained by videoendoscopy. The determination of the superovulatory response was better by colour Doppler ultrasonography in relation to the B-mode, because it allows a better delimitation of the luteal structures. Serum P4 concentrations were related inversely to the numbers of prematurely regressing CL (r = –0.70; P = 0.0004) and directly to the number of healthy CL (r = 0.69; P = 0.0005). The present results indicate that ultrasonographic imaging and serum P4 measurements on the day of embryo recovery are both very accurate indicators of ovarian responses in superovulated ewes.