Power and colour Doppler ultrasonography for the evaluation of the vasculature of the human corpus luteum

Abstract

We used power Doppler imaging to examine neovascularization in the corpus luteum (CL) in 12 healthy volunteers. We also investigated whether CL blood flow reflected luteal function. The ratio of the area of vessels in the CL to the area of a sectional plane at the maximum diameter of the CL observed by power Doppler (FA ratio) was used as a quantitative index of the vascularity of the CL. The pulsatility index (PI) was significantly lower in ovarian arteries with CL than without CL (P < 0.05). Changes in ovarian arterial and intra-luteal PI appeared to reflect physiological changes in the vasculature of the CL. There was no correlation between the volume of the CL or the FA ratio and the concentration of progesterone. The pattern of changes in the product of the FA ratio and the CL volume and in the progesterone concentration was similar. The progesterone concentration was positively correlated with this product (r = 0.74, P < 0.01). The product of the FA ratio and the CL volume plateaued during the mid- to late luteal phase, suggesting the presence of functional and structural luteolysis. These findings suggest that colour Doppler ultrasonography, including power Doppler imaging, can detect physiological changes in the blood flow of the ovary in the luteal phase, and may be a useful noninvasive tool for evaluating CL function.

Relationship of vascular perfusion of the wall of the preovulatory follicle to in vitro fertilisation and embryo development in heifers

“…The embryos were stained with DNA fluorochrome to visualise the nuclei of the blastomeres 120 h after the oocyte was exposed to spermatozoa. , Miyazaki et al 1998, Bhal et al 2001, mares , Silva et al 2006) and heifers (Siddiqui et al 2009b).…”

Novel prospects for evaluation of follicle wall blood flow using color-Doppler ultrasonography

“…When the overall color flow signals were displayed, estimated blood flow percentage scores were assigned subjectively by the operator's judgment. Although the subjective method for evaluation of follicle blood flow has been extensively used over a long period of time in women and domestic animals (Bourne et al, 1991;Brannstorm et al, 1998;Miyazaki et al, 1998;Gastal et al, 2006;Silva et al, 2006;Siddiqui et al, 2009a, b), its validity has not been sufficiently established. The accuracy between the subjective and objective methodologies to evaluate follicle wall blood flow has been deduced from reports that evaluated CL blood flow in heifers and mares (Ginther and Utt, 2004;Ginther et al, 2007a;Araujo and Ginther, 2009).…”

“…However, inadequateness regarding the reliability of those methods could be claimed because the approaches used for evaluating blood flow were different between both methods, i.e. continuous motion evaluation (Bhal et al, 1999;Gastal et al, 2006;Ginther, 2007) versus still image evaluation (Miyazaki et al, 1998;Ginther, 2007). Furthermore, the use of an objective pixel analysis method as a gold standard test to correlate findings with percentage or scoring evaluation in subjective methods could be questionable mainly for evaluations of blood flow in the follicle wall, considering the distinct geometry and morphological characteristics (Ali et al, 2001) (Gaytán et al, 1999;Hunter, 2003).…”

“…The first methodology involves the objective evaluation of the vascular perfusion of a structure (i.e., follicle, CL). Three images with maximum blood flow are selected using a video-editing program, and pixel aggregates are selected, extracted, saved, and processed using a specific software to generate the area of the colored pixels and the pixel number (Miyazaki et al, 1998;Acosta et al, 2002Acosta et al, , 2003Ginther, 2007;Ginther et al, 2007a;Araujo and Ginther, 2009). This method of evaluation has been used as a gold standard test to compare results with subjective methods (Ginther and Utt, 2004;Ginther et al, 2007a).…”

“…Although the subjective evaluation of follicle blood flow has been used in clinical and research settings in humans and farm species for more than two decades (Bourne et al, 1991;Miyazaki et al, 1998;Coulam et al, 1999;Shrestha et al, 2006;Silva et al, 2006;Siddiqui et al, 2009a, b), a validation of a methodology for evaluation of follicle blood flow, using subjective and objective approaches, has not been reported yet. Therefore, a validation and comparison between methodologies is needed.…”