Objective. A prospective study was performed to assess the usefulness of contrast-enhanced color Doppler ultrasound (CDUS) in the evaluation of intraarticular vascularization of finger joints in patients with rheumatoid arthritis (RA).Methods. We investigated 198 finger joints in 46 patients with RA, and 80 finger joints in 10 healthy volunteers. Joints with varying levels of clinical activity of inflammation were classified as being active, moderately active, or inactive. CDUS was performed with a high-frequency multi-D linear array transducer. A microbubble-based ultrasound (US) contrast agent (Levovist; Schering, Berlin, Germany) was intravenously infused. Doppler findings were rated on the basis of both unenhanced and contrast-enhanced CDUS images.Results. Healthy joints showed no intraarticular vascularization on either unenhanced or contrastenhanced CDUS. Unenhanced CDUS detected intraarticular vascularization in 7 (8%) of 83 inactive joints, in 31 (52%) of 60 moderately active joints, and in 32 (58%) of 55 active joints. Contrast-enhanced CDUS detected intraarticular vascularization in 41 (49%) of 83 joints with inactive RA, in 59 (98%) of 60 joints with moderately active RA, and in all 55 joints with active RA. Detection of intraarticular vascularization was improved by administration of the microbubble-based US contrast agent (P < 0.001). Contrast-enhanced CDUS demonstrated differences in intraarticular vascularization between joints with inactive RA and those with active RA (P < 0.001), between joints with inactive RA and those with moderately active RA (P < 0.001), and between joints with moderately active RA and those with active RA (P < 0.001). Conclusion. The use of a microbubble-based US contrast agent significantly improved the detection of intraarticular vascularization in the finger joints of patients with RA. This technique seems to be a useful adjunct in the assessment of disease activity.A crucial event in the pathogenesis of rheumatoid arthritis (RA) is the development of pannus (1). Proliferation of pannus is an early event in the course of the disease and can be seen before destruction of cartilage and bone. Vascularization of pannus appears to be crucial to its invasive and destructive behavior (2,3). Radiography is currently the method used for assessing the degree of actual joint destruction (4). Contrastenhanced magnetic resonance imaging (MRI) has also been utilized for this purpose, but this technique is not yet routinely available and is relatively cost-intensive and time-consuming (5,6).Hypervascularization of the pannus is usually caused by inflammatory activity. Color Doppler ultrasound (CDUS) imaging allows for detection of vascularity (6-11). CDUS combines the imaging capabilities of conventional B-mode ultrasound (US) with the bloodflow determinations of Doppler US and permits assessment of both the anatomy and the characteristics of blood flow of the vessels at specific sites. However, this technique is limited in the detection of slow flow and flow in small vessels. The add...
US shows a significantly higher prevalence of extratesticular and testicular disorders in these mountain bikers compared with nonbikers.
Our sono-morphological data and anatomical histological results strongly suggest that the rhabdosphincter constitutes the main component of the continence mechanism in post-prostatectomy patients. Unlike urethral pressure profiles, which can only reveal zones of higher intraluminal pressure between the bladder and the penile urethra, transurethral ultrasound is highly specific for measurement of the function of the rhabdosphincter.
Contradictory results have been obtained in classifying various renal diseases when trying to use the resistive index measured by duplex Doppler technique in renoparenchymal arteries. These measurements may have been influenced by the lack of standardization of the anatomic site at which the renoparenchymal artery is sampled. To elucidate this influence, we measured the resistive index, peak systolic velocity, end diastolic velocity, and pulsatility index in 120 healthy kidneys at three different positions of the renal vasculature. The resistive index at the level of the interlobar-arcuate arteries proved to be the parameter with the most consistent results and should be preferred in clinical applications.
The aim of our study was to evaluate the striated urethral sphincter (rhabdosphincter) in incontinent females by means of intraurethral ultrasound (IUUS). Thirty-four incontinent and 11 continent female patients were examined by means of 12.5-MHz endoluminal ultrasound (US). The distance between the inner contour of the sphincter muscle and the US catheter was measured in the contracted and the non-contracted condition. The US findings were correlated with those obtained by urodynamic studies. Partial or complete loss of sphincter function was detected in patients with stress urinary incontinence (SUI). Reduced sphincter function was not observed in patients with urge incontinence and continent volunteers. The findings on US were found to correlate well with the grade of SUI. The IUUS technique offers the benefit of direct visualization of the sphincter mechanism. Therefore, endoluminal US may become an important adjunct in the diagnostic evaluation of SUI and will possibly provide new insights for a better therapeutic strategy.
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