Transcranial Doppler (TCD) is used to detect children with sickle cell anemia (SCA) who are at risk for stroke, and transfusion programs significantly reduce stroke risk in patients with abnormal ...TCD. We describe the predictive factors and outcomes of cerebral vasculopathy in the Créteil newborn SCA cohort (n = 217 SS/Sβ0), who were early and yearly screened with TCD since 1992. Magnetic resonance imaging/magnetic resonance angiography was performed every 2 years after age 5 (or earlier in case of abnormal TCD). A transfusion program was recommended to patients with abnormal TCD and/or stenoses, hydroxyurea to symptomatic patients in absence of macrovasculopathy, and stem cell transplantation to those with human leukocyte antigen-genoidentical donor. Mean follow-up was 7.7 years (1609 patient-years). The cumulative risks by age 18 years were 1.9% (95% confidence interval 95% CI 0.6%-5.9%) for overt stroke, 29.6% (95% CI 22.8%-38%) for abnormal TCD, which reached a plateau at age 9, whereas they were 22.6% (95% CI 15.0%-33.2%) for stenosis and 37.1% (95% CI 26.3%-50.7%) for silent stroke by age 14. Cumulating all events (stroke, abnormal TCD, stenoses, silent strokes), the cerebral risk by age 14 was 49.9% (95% CI 40.5%-59.3%); the independent predictive factors for cerebral risk were baseline reticulocytes count (hazard ratio 1.003/L × 109/L increase, 95% CI 1.000-1.006; P = .04) and lactate dehydrogenase level (hazard ratio 2.78/1 IU/mL increase, 95% CI1.33-5.81; P = .007). Thus, early TCD screening and intensification therapy allowed the reduction of stroke-risk by age 18 from the previously reported 11% to 1.9%. In contrast, the 50% cumulative cerebral risk suggests the need for more preventive intervention.
Doppler ultrasound–guided volumizing of the glabella Teixeira, Danilo Augusto; Santos, Grasielle Silva; Teixeira, Fábio Henrique
Journal of the American Academy of Dermatology,
April 2022, 2022-04-00, 20220401, Letnik:
86, Številka:
4
Journal Article
Doppler ultrasound protocol for patients with hidradenitis suppurativa Denofre, Ariany Tomaz de Aquino Saran; Stecca, Carolina Meloni; Serrano, Juliana Yumi Massuda ...
Anais brasileiros de dermatología,
September-October 2024, 2024-09-00, 20240901, Letnik:
99, Številka:
5
Journal Article
Recenzirano
Odprti dostop
Hidradenitis suppurativa (HS) is a chronic inflammatory disease that leads to the formation of nodules, abscesses and fistulas, with the formation of scars and fibrosis, causing significant ...impairment in patient quality of life. The diagnosis is clinical, using scores to classify the severity of the condition; currently the most recommended classification is the International Hidradenitis Suppurativa Severity Scoring System (IHS4). Doppler ultrasound has been used to complement the clinical evaluation of patients with HS. It is possible to observe subclinical lesions that change the staging, the severity of the case, and its treatment, either clinical or surgical. Correct treatment is essential to minimize the consequences of this disease for the patient.
To establish an outpatient protocol for the use of Doppler ultrasound in the care of patients with HS.
A narrative review of the literature was carried out on the use of Doppler ultrasound in patients with hidradenitis suppurativa; a referring protocol and technique orientations for imaging assessment in HS were created.
Recommendation to perform ultrasound evaluation of symptomatic areas eight weeks after using antibiotics and four, 12, and 24 weeks after starting immunobiologicals; apply SOS-HS ultrasound severity classification.
The review did not cover all literature on ultrasound and HS; no systematic review was carried out, but rather a narrative one.
The correct assessment of patients staging must be carried out using dermatological ultrasound to avoid progression to scars and fibrosis, which compromise patients quality of life.
The main applications and features of functional ultrasound (fUS) imaging. fUS imaging provides (i) a compatibility with a wide range of animal models for preclinical studies, (ii) the ability to ...image awake and freely moving animals, (iii) possibility to combine with super-resolution ultrasound localization microscopy, (iv) possible extension to 3D imaging, (v) functional connectivity mapping for brain connectomics, (vi) translation to clinical neuroimaging in human neonates or (vii) peroperative neuroimaging during brain surgery and (viii) EEG compatibility for EEG-fUS recordings.▪
•Ultrafast plane wave ultrasound allows high sensitivity flow imaging in the brain.•fUS (functional ultrasound) imaging provides whole-brain functional imaging with high spatiotemporal resolution.•fUS imaging can be used in combination with EEG in awake freely moving animals.•fUS imaging can be used for functional brain connectomics and pharmacological studies.•fUS imaging has a high potential for rapid translation to clinical neuroimaging.
In the last decade, ultrasound imaging has gained new capabilities and produced new insights in the field of neuroscience. The development of new concepts, such as ultrafast ultrasound, has enhanced Doppler sensitivity by orders of magnitude and has paved the way for ultrasonic functional neuroimaging. In this review, we position ultrasound in the field of neuroimaging and discuss how it complements current tools available to neurobiologists and clinicians.
Objective
Musculoskeletal ultrasonography (US) has the potential to be an important tool in the assessment of disease activity in childhood arthritides. To assess pathology, clear definitions for ...synovitis need to be developed first. The aim of this study was to develop and validate these definitions through an international consensus process.
Methods
The decision on which US techniques to use and the components to be included in the definitions, as well as the final wording, were developed by 31 US experts in a consensus process. A Likert scale of 1–5 (where 1 = complete disagreement and 5 = complete agreement) was used. A minimum of 80% of the experts scoring 4 or 5 was required for final approval. The definitions were then validated on 120 standardized US images of the wrist, metacarpophalangeal joints, and tibiotalar joints, displaying various degrees of synovitis at various ages.
Results
B‐mode and Doppler should be used for assessing synovitis in children. A US definition of the various components (i.e., synovial hypertrophy, effusion, and Doppler signal within the synovium) was developed. The definition was validated on still images with a median of 89% of participants (range 80–100) scoring it as 4 or 5 on a Likert scale.
Conclusion
US definitions of synovitis and its elementary components covering the entire pediatric age range were successfully developed through a Delphi process and validated in a web‐based still‐images exercise. These results provide the basis for the standardized US assessment of synovitis in clinical practice and research.
Blood flow speed is an important functional parameter. Doppler ultrasound flowmetry lacks sufficient sensitivity to slow blood flow (several to tens of millimeters per second) in deep tissue. To ...address this challenge, we developed ultrasonically encoded photoacoustic flowgraphy combining ultrasonic thermal tagging with photoacoustic imaging. Focused ultrasound generates a confined heat source in acoustically absorptive fluid. Thermal waves propagate with the flow and are directly visualized in pseudo color using photoacoustic computed tomography. The Doppler shift is employed to calculate the flow speed. This method requires only acoustic and optical absorption, and thus is applicable to continuous fluid. A blood flow speed as low as 0.24 mm·s(-1)} was successfully measured. Deep blood flow imaging was experimentally demonstrated under 5-mm-thick chicken breast tissue.
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