-
Artigos Originais
The influence of the site of middle cerebral doppler flow analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(3):137-142
03-06-2005
Summary
Artigos OriginaisThe influence of the site of middle cerebral doppler flow analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(3):137-142
03-06-2005DOI 10.1590/S0100-72032005000300007
Views104See morePURPOSE: to evaluate if there is any difference between Doppler indexes in the middle cerebral artery in two different sites of insonation in healthy patients and in patients with diseases. METHODS: a random prospective survey, in the period from June 2003 to March 2004 that analyzed the Doppler indexes of 100 patients: patient group (n = 50) included patients admitted to Clemente Farias University Hospital, which is part of UNIMONTES-MG, havinfg as inclusion criteria: to be in the 28th to 34th gestational week, diagnosis of chronic arterial hypertension, pre-eclampsia, intrauterine growth restriction. As control group, 50 healthy pregnant patients between the 28th and the 34th week, originary from SEMESP's clinic. The Doppler variables were the resistance index (RI), the pulsatility index (PI) and the relation systole/diastole (SD). All three Doppler indexes were assessed at two different sites of the cerebral artery: the first measurement in the diencephalons region, soon after the beginning of the middle cerebral artery and the second on a distal location in the telencephalon. The median Doppler indexes in the patient group in the first and second measurements were 1.55 and 1.69 for the PI, 0.77 and 0.79 for RI and 4.29 and 4.86 for SD, respectively. In the control group, the values were 1.73 and 1.86 for the PI; 0.83 and 0.79 for RI and 5.83 and 5.46 for SD. There were no differences between sites with a p value of 0.38, 0.29 and 0.39 for PI, RI and SD, respectively. In 15t fetuses with centralization (brain sparing effects), in the diencephalon the median indexes were 1.02 for PI, 0.63 for RI and 2.68 for SD. In the epencephalon the median indexes were 0.95 for IP, 0.62 for RI and 2.44 for SD. There were no differences between sites, with a p value of 0.53 for PI; 0.56 for IR and 0.31 for SD. The Doppler index site of assessment in the middle cerebral arteries does not interfere with the results.
Views104
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisThe influence of the site of middle cerebral doppler flow analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(3):137-142
03-06-2005DOI 10.1590/S0100-72032005000300007
Views104See morePURPOSE: to evaluate if there is any difference between Doppler indexes in the middle cerebral artery in two different sites of insonation in healthy patients and in patients with diseases. METHODS: a random prospective survey, in the period from June 2003 to March 2004 that analyzed the Doppler indexes of 100 patients: patient group (n = 50) included patients admitted to Clemente Farias University Hospital, which is part of UNIMONTES-MG, havinfg as inclusion criteria: to be in the 28th to 34th gestational week, diagnosis of chronic arterial hypertension, pre-eclampsia, intrauterine growth restriction. As control group, 50 healthy pregnant patients between the 28th and the 34th week, originary from SEMESP's clinic. The Doppler variables were the resistance index (RI), the pulsatility index (PI) and the relation systole/diastole (SD). All three Doppler indexes were assessed at two different sites of the cerebral artery: the first measurement in the diencephalons region, soon after the beginning of the middle cerebral artery and the second on a distal location in the telencephalon. The median Doppler indexes in the patient group in the first and second measurements were 1.55 and 1.69 for the PI, 0.77 and 0.79 for RI and 4.29 and 4.86 for SD, respectively. In the control group, the values were 1.73 and 1.86 for the PI; 0.83 and 0.79 for RI and 5.83 and 5.46 for SD. There were no differences between sites with a p value of 0.38, 0.29 and 0.39 for PI, RI and SD, respectively. In 15t fetuses with centralization (brain sparing effects), in the diencephalon the median indexes were 1.02 for PI, 0.63 for RI and 2.68 for SD. In the epencephalon the median indexes were 0.95 for IP, 0.62 for RI and 2.44 for SD. There were no differences between sites, with a p value of 0.53 for PI; 0.56 for IR and 0.31 for SD. The Doppler index site of assessment in the middle cerebral arteries does not interfere with the results.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Performance of ultrasound in the detection of axillary lymph node metastases in breast cancer patients
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):534-540
01-30-2005
Summary
Artigos OriginaisPerformance of ultrasound in the detection of axillary lymph node metastases in breast cancer patients
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):534-540
01-30-2005DOI 10.1590/S0100-72032005000900006
Views90See morePURPOSE: to evaluate the role of morphological (12) and Doppler velocimetry (17) ultrasonographic features, in the detection of lymph node metastases in breast cancer patients. METHODS: 179 women (181 axillary cavities) were included in the study from January to December 2004. The ultrasonographic examinations were performed with a real-time linear probe (Toshiba-Power Vision-6000 (model SSA-370A)). The morphological parameters were studied with a frequency of 7.5-12 MHz. A frequency of 5 MHz was used for the Doppler velocimetry parameters. Subsequently, the women were submitted to level I, II and III axillary dissection (158), or to the sentinel lymph node technique (23). Sensitivity, specificity, and positive and negative predictive values were calculated for each parameter. The decision tree test was used for parameter association. The cutoff points were established by the ROC curve. RESULTS: at least one lymph node was detected in 173 (96%) of the women by the ultrasonographic examinations. Histological examination detected lymph node metastases in 87 women (48%). The best sensitivity among the morphological paramenters was found with the volume (62%), the antero-posterior diameter (62%) and the fatty hilum placement (56%). Though the specificity of the extracapsular invasion (100%), border regularity (92%) and cortex echogenicity (99%) were high, the sensitivity of these features was too low. None of the Doppler velocimetry parameters reached 50% sensitivity. The decision tree test selected the ultrasonographic parametners: fatty hilum placement, border regularity and cortex echogenicity, as the best parameter association. CONCLUSION: the detection of axillary cavity lymph node stage by a noninvasive method still remains an unfulfilled goal in the treatment of patients with breast cancer.
Views90This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisPerformance of ultrasound in the detection of axillary lymph node metastases in breast cancer patients
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):534-540
01-30-2005DOI 10.1590/S0100-72032005000900006
Views90See morePURPOSE: to evaluate the role of morphological (12) and Doppler velocimetry (17) ultrasonographic features, in the detection of lymph node metastases in breast cancer patients. METHODS: 179 women (181 axillary cavities) were included in the study from January to December 2004. The ultrasonographic examinations were performed with a real-time linear probe (Toshiba-Power Vision-6000 (model SSA-370A)). The morphological parameters were studied with a frequency of 7.5-12 MHz. A frequency of 5 MHz was used for the Doppler velocimetry parameters. Subsequently, the women were submitted to level I, II and III axillary dissection (158), or to the sentinel lymph node technique (23). Sensitivity, specificity, and positive and negative predictive values were calculated for each parameter. The decision tree test was used for parameter association. The cutoff points were established by the ROC curve. RESULTS: at least one lymph node was detected in 173 (96%) of the women by the ultrasonographic examinations. Histological examination detected lymph node metastases in 87 women (48%). The best sensitivity among the morphological paramenters was found with the volume (62%), the antero-posterior diameter (62%) and the fatty hilum placement (56%). Though the specificity of the extracapsular invasion (100%), border regularity (92%) and cortex echogenicity (99%) were high, the sensitivity of these features was too low. None of the Doppler velocimetry parameters reached 50% sensitivity. The decision tree test selected the ultrasonographic parametners: fatty hilum placement, border regularity and cortex echogenicity, as the best parameter association. CONCLUSION: the detection of axillary cavity lymph node stage by a noninvasive method still remains an unfulfilled goal in the treatment of patients with breast cancer.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Peak systolic velocity and resistance index of fetal arteries during the second half of pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):387-392
11-16-2005
Summary
Artigos OriginaisPeak systolic velocity and resistance index of fetal arteries during the second half of pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):387-392
11-16-2005DOI 10.1590/S0100-72032005000700004
Views50See morePURPOSE: to assess peak systolic velocity (PSV) and the resistance index (RI) in the middle cerebral artery (MCA), suprarenal aorta (SRA) and infrarenal aorta (IRA) of the fetus and in the umbilical artery (UA) between the 22nd and 38th week of gestation. METHODS: a prospective study which evaluated the parameters of 33 normal fetuses in the 22nd, 26th, 30th, and 38th week of gestation. Pregnant women with a singleton fetus with no diseases or complications and who agreed to participate were included in the study. Exclusion criteria were fetal malformations, discontinuation of prenatal care visits and mothers who smoked, used alcohol or illicit drugs. Ultrasound examinations were performed by a single observer. For the acquisition of the Doppler velocimetry tracing in the MCA, SRA, IRA and UA, the sample volume was 1 to 2 mm, placed in the center of the arteries. The insonation angle was 5º to 19º in the MCA, below 45º in the SRA and IRA, and less than 60º in the UA. We used a wall filter of 50-100 Hz. The parameters were calculated automatically with the frozen image, three measurements being made. The final result was obtained by the arithmetic mean of the three values. Data were analyzed by analysis of variance (ANOVA), post hoc Bonferroni test, Pearson's correlation, and regression analysis. The level of significance was set at p<0.05 in all analyses. RESULTS: PSV increased from 26.3 to 57.7 cm/s in the MCA between the 22nd and the 38th week of gestation (p<0.05). In the SRA and in the IRA, PSV increased between the 22nd and 34th week of gestation, from 74.6 and 59.0 cm/s to 106.0 and 86.6 cm/s, respectively (p<0.05). In the UA, PSV increased between the 22nd and the 34th week of gestation, but decreased from 55.5 to 46.2 cm/s between the 34th and the 38th week of gestation. In the MCA, the RI was lower in the 22nd (0.81) and 38th week of gestation (0.75) and higher (0.85) in the 26th week (p<0.05). In the SRA, the RI values were stable in all weeks and in the IRA they were stable in most weeks (p>0.05). In the UA, RI decreased from 0.69 to 0.56 between the 22nd and 38th week of gestation (p<0.05). CONCLUSION: in normal fetuses, in the second half of gestation PSV increased in the MCA, SRA and IRA, decreasing in the UA between the 34th and 38th week of gestation. RI was lower in the 22nd and 38th weeks of gestation in the MCA, decreased between the 22nd and the 38th week in the UA, and was constant in most of the gestational weeks in the SRA and IRA.
Views50This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisPeak systolic velocity and resistance index of fetal arteries during the second half of pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):387-392
11-16-2005DOI 10.1590/S0100-72032005000700004
Views50See morePURPOSE: to assess peak systolic velocity (PSV) and the resistance index (RI) in the middle cerebral artery (MCA), suprarenal aorta (SRA) and infrarenal aorta (IRA) of the fetus and in the umbilical artery (UA) between the 22nd and 38th week of gestation. METHODS: a prospective study which evaluated the parameters of 33 normal fetuses in the 22nd, 26th, 30th, and 38th week of gestation. Pregnant women with a singleton fetus with no diseases or complications and who agreed to participate were included in the study. Exclusion criteria were fetal malformations, discontinuation of prenatal care visits and mothers who smoked, used alcohol or illicit drugs. Ultrasound examinations were performed by a single observer. For the acquisition of the Doppler velocimetry tracing in the MCA, SRA, IRA and UA, the sample volume was 1 to 2 mm, placed in the center of the arteries. The insonation angle was 5º to 19º in the MCA, below 45º in the SRA and IRA, and less than 60º in the UA. We used a wall filter of 50-100 Hz. The parameters were calculated automatically with the frozen image, three measurements being made. The final result was obtained by the arithmetic mean of the three values. Data were analyzed by analysis of variance (ANOVA), post hoc Bonferroni test, Pearson's correlation, and regression analysis. The level of significance was set at p<0.05 in all analyses. RESULTS: PSV increased from 26.3 to 57.7 cm/s in the MCA between the 22nd and the 38th week of gestation (p<0.05). In the SRA and in the IRA, PSV increased between the 22nd and 34th week of gestation, from 74.6 and 59.0 cm/s to 106.0 and 86.6 cm/s, respectively (p<0.05). In the UA, PSV increased between the 22nd and the 34th week of gestation, but decreased from 55.5 to 46.2 cm/s between the 34th and the 38th week of gestation. In the MCA, the RI was lower in the 22nd (0.81) and 38th week of gestation (0.75) and higher (0.85) in the 26th week (p<0.05). In the SRA, the RI values were stable in all weeks and in the IRA they were stable in most weeks (p>0.05). In the UA, RI decreased from 0.69 to 0.56 between the 22nd and 38th week of gestation (p<0.05). CONCLUSION: in normal fetuses, in the second half of gestation PSV increased in the MCA, SRA and IRA, decreasing in the UA between the 34th and 38th week of gestation. RI was lower in the 22nd and 38th weeks of gestation in the MCA, decreased between the 22nd and the 38th week in the UA, and was constant in most of the gestational weeks in the SRA and IRA.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Uterine artery doppler velocimetry for the prediction of complications in low-risk pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(6):323-330
11-11-2005
Summary
Artigos OriginaisUterine artery doppler velocimetry for the prediction of complications in low-risk pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(6):323-330
11-11-2005DOI 10.1590/S0100-72032005000600006
Views74See morePURPOSE: to determine the validity of uterine artery Doppler velocimetry for the prediction of pregnancy complications in a population of low-risk nulliparae. SUBJECTS: a prospective study was conducted on 45 patients in their first pregnancy with no history of chronic diseases. Uterine artery Doppler velocimetry was performed between 24 and 26 weeks, with the determination of resistance index (RI), pulsatility index (PI), S/D ratio, and the presence or absence of incisure in the flow velocity wave. Data were analyzed by the Mann-Whitney test for non-parametric samples, and the Fisher exact test was used in the evaluation of the qualitative parameters. RESULTS: pregnancy complications were observed in twelve patients, with four cases of preeclampsia, one case of small for gestational age newborn (SGA NB), one case of SGA NB + preterm delivery (PTD), three cases of PTD, one case of fetal centralization, and two cases of presence of thick meconium in the amniotic fluid at the time of pregnancy resolution. We noted that RI (median 0.56 x 0.68), PI (median 0.98 x 1.29) and S/D ratio (median 2.2 x 2.9) were higher at the examination performed between 24 and 26 weeks in patients with complications and did not differ in preeclampsia and SGA cases. The presence of bilateral incisure showed 100 and 90% sensitivity, 60.2 and 62.5% specificity, 29.4 and 42,9% positive predictive value (PPV), and 100 and 95.2% negative predictive value (NPV) for the detection of preeclampsia or SGA and of any complication of pregnancy, respectively. An altered Doppler showed 83.3 and 83.3% sensitivity, 69.7 and 69.7% specificity, 33.3 and 50.0% PPV, and 95.8 and 92.0% NPV for the detection of preeclampsia or SGA and of any complication of pregnancy, respectively. CONCLUSION: high impedance indices and the presence of a bilateral incisure in the uterine arteries between 24 and 26 weeks of pregnancy seem to be good predictors of pregnancy and perinatal complications.
Views74This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisUterine artery doppler velocimetry for the prediction of complications in low-risk pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(6):323-330
11-11-2005DOI 10.1590/S0100-72032005000600006
Views74See morePURPOSE: to determine the validity of uterine artery Doppler velocimetry for the prediction of pregnancy complications in a population of low-risk nulliparae. SUBJECTS: a prospective study was conducted on 45 patients in their first pregnancy with no history of chronic diseases. Uterine artery Doppler velocimetry was performed between 24 and 26 weeks, with the determination of resistance index (RI), pulsatility index (PI), S/D ratio, and the presence or absence of incisure in the flow velocity wave. Data were analyzed by the Mann-Whitney test for non-parametric samples, and the Fisher exact test was used in the evaluation of the qualitative parameters. RESULTS: pregnancy complications were observed in twelve patients, with four cases of preeclampsia, one case of small for gestational age newborn (SGA NB), one case of SGA NB + preterm delivery (PTD), three cases of PTD, one case of fetal centralization, and two cases of presence of thick meconium in the amniotic fluid at the time of pregnancy resolution. We noted that RI (median 0.56 x 0.68), PI (median 0.98 x 1.29) and S/D ratio (median 2.2 x 2.9) were higher at the examination performed between 24 and 26 weeks in patients with complications and did not differ in preeclampsia and SGA cases. The presence of bilateral incisure showed 100 and 90% sensitivity, 60.2 and 62.5% specificity, 29.4 and 42,9% positive predictive value (PPV), and 100 and 95.2% negative predictive value (NPV) for the detection of preeclampsia or SGA and of any complication of pregnancy, respectively. An altered Doppler showed 83.3 and 83.3% sensitivity, 69.7 and 69.7% specificity, 33.3 and 50.0% PPV, and 95.8 and 92.0% NPV for the detection of preeclampsia or SGA and of any complication of pregnancy, respectively. CONCLUSION: high impedance indices and the presence of a bilateral incisure in the uterine arteries between 24 and 26 weeks of pregnancy seem to be good predictors of pregnancy and perinatal complications.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Laser-doppler flowmetry Archives - Revista Brasileira de Ginecologia e Obstetrícia
