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ABSTRACT: The purpose of the study was to assess the quality of performance of wideband, phase inversion harmonic power Doppler sonography in the diagnosis of focal nodular.
During a period of one year, thirty-one patients with FNH previously confirmed by ultrasound-guided biopsy, surgical resection, dynamic helical computed tomography or magnetic resonance imaging were examined. The study protocol consisted of B-mode gray scale sonography, color Doppler, power Doppler examinations, and helical CT scans. Then PI scans were performed after the injection of 2.5 g of Levovist intravenously.
The images obtained by the B-mode gray scale were typical for focal nodular hyperplasia in 13 lesions only (32.5%), and obtained by color, power Doppler sonography in 25 lesions (62%). On the contrary all patients with focal nodular hyperplasia were diagnosed based on the wide-band, phase inversion power Doppler sonography findings. The common enhancement pattern at pulseinversion harmonic US was filling in a central tumor artery with further centrifugal development of contrast. Then during early arterial phase, all typical anatomical features of FNH as 'star sign 'or 'spoke-wheel 'pattern were clearly visible .In 3 cases ,computed tomography and magnetic resonance imaging have failed to disclose pathology while phase inversion sonographic images were completely suggestive which was later confirmed by histologic examination.
Our data demonstrates the usefulness of wide-band, phase inversion harmonic power Doppler sonography in the differential diagnosis of hepatic focal nodular hyperplasia by visualizing all characteristic anatomical details.
Medical science monitor: international medical journal of experimental and clinical research 07/2004; 10 Suppl 3:17-21. · 1.70 Impact Factor
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ABSTRACT: Early diagnosis of hepatocellular carcinoma (HCC) is extremely important because surgical resection and local ablation therapy are undoubtfully the most effective treatment regiment. Recent advances in sonographic techniques have risen the question ofsonography utility. The scope of this investigation was to assess the detection accuracy of tumor vascularity in HCC by contrast-enhanced, wide-band phase inversion (PI) power Doppler sonography.
Twenty-one patients were examined with 21 nodules (16 hypo-, 2 iso-, 3 hyperechoic nodules). The presence of hepatocellular carcinoma was confirmed by fine-needle biopsy results in 16 nodules, and the diagnosis in the remaining tumors was based on imaging findings and tumor markers. All patients, prior to enhanced sonography, had undergone both the native B-mode and tissue harmonic imaging mode sonography, color Doppler, and power Doppler examinations.
Three patients were excluded. 18 nodules evaluation by contrast-enhanced, wide-band PI power Doppler US revealed tumor vessels in 100% cases in arterial phase. The characteristic chaotic pattern of lesions vascularity was evidently pronounced. Rapid increase of enhancement during the arterial and slow decrease of enhancement during the portal phase were the special features of HCCs helping in making the final diagnosis. Power Doppler sonography detection rates were 14 cases (77%).
Based on our results we can recommend wide-band, phase inversion power Doppler sonography in the differential diagnosis of HCC by visualizing characteristic behavior of enhancement pattern in the most cases.
Medical science monitor: international medical journal of experimental and clinical research 07/2004; 10 Suppl 3:32-5. · 1.70 Impact Factor
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ABSTRACT: Contrast-enhanced, wide-band, phase inversion power Doppler sonography in the depiction of vasculature in hemangioma and focal nodular hyperplasia.
Fifty-one patients with liver lesions (40 FNHs,37 hemangiomas) were prospectively evaluated with conventional, color, power Doppler sonography, tissue harmonic, phase-inversion sonography and helical CT. Levovist was the standard contrast agent used and all examinations were performed on Siemens SONOLINE Elegra equipped with Ensemble Contrast Imaging (ECI) software.
Color and power Doppler scans were frequently not specific for these highly vasularized lesions. Images were not suggestive in 15 out of 40 FNHs and not positive in all of 37 hemangiomas). If peripheral enhancement in form of puddle enhancement, 'bloo pools' or rimlike followed by a slow centripetal fill-in is regarded as a positive finding for hemangiomas all lesions were depicted confidently with wide-band, phase inversion, contrast enhanced power Doppler scans. Moreover, all typical vascularity features of FNHs confluence firstly the feeding artery then centrifugal spread of contrast later forming wheel like pattern was obvious in all cases of diagnosed FNHs.
Contrast-enhanced, wide-band, PI ,power Doppler imaging is useful method for diagnosing the vascularity of FNHs and hemangiomas. Not only it overcomes the low prediction rate which was the main obstacle for routine use of sonography but it is cheap, portable, and free also from contrast media and radiation.
Medical science monitor: international medical journal of experimental and clinical research 07/2004; 10 Suppl 3:26-31. · 1.70 Impact Factor
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ABSTRACT: In men, androgens and especially testosterone are considered responsible for the much higher rate of coronary artery disease. The male gender is an independent coronary artery disease risk factor. An adverse correlation between endogenous testosterone levels and the extent of coronary atherosclerosis has been demonstrated in just one study. In our study, we investigated the associations between endogenous sex hormone levels and the extent of coronary atherosclerosis, ejection fraction of the left ventricle and coronary heart disease risk factors.
Przegla̧d lekarski 02/2004; 61(8):876-9.
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ABSTRACT: We evaluated the usefulness of three-dimensional (3D) sonography in percutaneous fine-needle pancreatic pseudocyst puncture.
We examined 52 patients diagnosed as having pancreatic pseudocysts on the basis of clinical symptoms and two-dimensional (2D) ultrasonography findings. The decision to qualify certain patients for percutaneous fine-needle aspiration guided by ultrasonography was made on the basis of 2D and 3D scan results. Spiral computed tomography was done when the presence of connections between pseudocyst and pancreatic duct was suspected. In these cases diagnosis was confirmed in operative procedures. 3D sonography was used to monitor the tip of the needle making its way to the pancreatic pseudocyst and later inside the fluid collection.
Pancreatic pseudocysts were diagnosed in all 52 cases; 48 patients underwent percutaneous fine-needle biopsies.
3D presentation can better visualize irregular shapes, local thickenings, and calcification of pseudocyst walls than classical 2D ultrasound scans. The use of subtraction in 3D scans of blood vessels increases the safety in performing biopsies. We have shown that 3D sonography collects extremely useful information about the status of the pseudocyst structure, and it should become a complementary method to classical ultrasonography. This technique when used on a routine basis should help us change the inclusion criteria for guided biopsies.
Journal of Hepato-Biliary-Pancreatic Surgery 02/2004; 11(3):159-63. · 1.60 Impact Factor
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ABSTRACT: This clinical study investigated the possible associations of male sex hormone with the extensiveness of coronary artery lesions, coronary heart disease risk factors and ejection fraction of the heart. Ninety six Caucasian male subjects were recruited, 76 with positive and 20 with negative coronary angiograms. Early morning, prior to haemodynamic examination all of them had determined levels of total testosterone, free testosterone, free androgen index (FAI), sex hormone-binding globulin (SHBG), oestradiol, luteinizing hormone, follicle-stimulating hormone, plasma lipids, fibrinogen and glucose. The ejection fraction and the extensiveness of coronary lesions of each subject was assessed on the basis of x-ray examination results using Quantitative Coronary Angiography (QCA) and Left Ventricular Analysis (LVA) packages on the TCS Acquisition workstation, Medcon. Men with proven coronary heart disease had significantly lower levels of total testosterone (11.9 vs 21.2 nmol/l), free testosterone (45.53 vs 86.10 pmol/l), free androgen index (36.7 vs 47.3 IU) and oestradiol (109.4 vs 146.4 pmol/l). The level of testosterone was negatively associated with the DUKE Index. The most essential negative correlation was observed between SHBG and atherogenic lipid profile (low high-density lipoprotein, high triglycerides). Ejection fraction was substantially lower in patients (51.85 vs 61.30) (without prior myocardial infarction) with low levels of free-testosterone (23.85 vs. 86.10 pmol/l) and FAI (28.4 vs 47.3 IU). A negative correlation was observed between total testosterone, free testosterone, FAI and blood pressure, especially with diastolic pressure. Men with proven coronary atherosclerosis had lower levels of endogenous androgens than the healthy controls. For the first time in clinical settings it has been demonstrated that low levels of free-testosterone was characteristic for patients with low ejection fraction. Numerous hypothesies for this action can be proposed but all require a proper evaluation process. The main determinant of atherogenic plasma lipid was low levels of SHBG suggesting its main role in developing atheroscerotic lesions.
The Journal of Medical Investigation 09/2003; 50(3-4):162-9.
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ABSTRACT: BACKGROUND. The aim of this study was to evaluate the efficacy of three-dimensional (3D) sonography in liver biopsies. Primarily, the diagnosis of hepatic tumors is based on 2D sonography. This method allows the noninvasive evaluation of the anatomical structure and tumor localization. Interpretation difficulties emerge most often during the assessment of tumor boundaries and their relationships to the blood vessels.
The study included 19 patients, aged 40-75 years (average, 57.5 years) admitted to the Department of General Surgery due to diagnosed liver tumors.
The livers of all the examined patients displayed focal changes. In order to obtain material for histopathologic examinations, percutaneous needle biopsies were performed, with no complications.
3D sonography generated more information about hepatic changes, due to imaging of multiplanar reconstructions in oblique presentations (which are impossible to present in classical 2D), and thus facilitated design of the biopsy. Evaluation of the biopsy needle visualization inside the tumor with the use of both the 2D and the 3D presentations depends on the subjective approach of the examiner. Based on our knowledge and experience in ultrasonography-guided needle biopsy, we believe 3D sonography-guided biopsy has high efficacy.
Journal of Hepato-Biliary-Pancreatic Surgery 02/2003; 10(1):87-9. · 1.60 Impact Factor
