The role of power Doppler sonography in the evaluation of superficial soft tissue abscesses

Arslan, Halil; Sakarya, Mehmet Emin; Bozkurt, Mehmet; Ünal, Özkan; Dılek, Osman Nuri; Harman, Mustafa

doi:10.1016/s0929-8266(98)00065-2

Cited by 50 publications

(22 citation statements)

References 7 publications

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“…13 16 17 In the case of CD patients, this characteristic is conceivable if we consider that abscesses arise in or around a fistulous track: although it is difficult to separate fistulae tracts from the abscess walls, we believe that power Doppler can be used to differentiate abscesses from inflammatory masses or fistulae, although larger scale studies are necessary to confirm these preliminary findings.…”

Section: Discussionmentioning

confidence: 97%

The vascularity of internal fistulae in Crohn's disease: an in vivo power Doppler ultrasonography assessment

Maconi

Sampietro²,

Russo³

et al. 2002

Gut

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Aim: To evaluate the efficacy of power Doppler sonography (US) in depicting internal fistulae and their vascularity, and to study the characteristics of blood flow within the fistula wall. Patients and methods: The study involved 45 consecutive patients with Crohn's disease and suspected internal fistulae detected by grey scale US. The fistulae were subsequently evaluated using power Doppler US to reveal any areas of increased vascularity, and the results were compared with radiographic, endoscopic, or intraoperative findings. Whenever feasible, we also performed spectral analysis of blood flow revealed by power Doppler US, calculated its resistance index (RI), and analysed its characteristics, reproducibility, and relationship with biochemical and clinical variables (Crohn's disease activity index, disease duration, location, and abdominal complications). Results: Power Doppler US revealed vascularity in all of the internal fistulae that where subsequently confirmed by diagnostic procedures. In the case of intra-abdominal abscesses in the vicinity of the fistula, vascular signals were detected mostly around and not within the lesions. The intensity and distribution of the signals differed within the fistulae tracks and had only slight day to day reproducibility; furthermore, there was no significant correlation with clinical or biochemical variables. Spectral analyses of blood flow within the fistulae revealed arterial flow in 96.7% of patients (median RI 0.715). RI was a more reproducible parameter and significantly correlated with clinical (r= 0.54) and biochemical activity (r= 0.56) of CD. It was also higher in fistulae complicated by abscesses. Conclusion: Power Doppler US can reveal the presence of vasculature within the wall of internal fistulae and therefore enhance grey scale US performance. The RI characteristics of blood flow within the fistulae are reproducible and correlate with biochemical and clinical disease activity.

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Section: Discussionmentioning

confidence: 97%

The vascularity of internal fistulae in Crohn's disease: an in vivo power Doppler ultrasonography assessment

Maconi

Sampietro²,

Russo³

et al. 2002

Gut

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“…[29][30][31] The physicians were taught to make their assessment based on gray-scale findings only. We believe that this approach requires less time to learn and less actual time to scan the patient.…”

Section: Discussionmentioning

confidence: 99%

ABSCESS: Applied Bedside Sonography for Convenient Evaluation of Superficial Soft Tissue Infections

Squire¹,

Fox²,

Anderson³

2005

Acad Emergency Med

108

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Objectives: Soft tissue infections are a common presenting complaint in the emergency department (ED). The authors sought to determine the utility of ED bedside ultrasonography (US) in detecting subcutaneous abscesses. Methods: Between August 2003 and November 2004, a prospective, convenience sample of adult patients with a chief complaint suggestive of cellulitis and/or abscess was enrolled. US was performed by attending physicians or residents who had attended a 30-minute training session in soft tissue US. The treating physician recorded a yes/no assessment of whether he or she believed an abscess was present before and after the US examination. Incision and drainage (I 1 D) was the criterion standard when performed, while resolution on seven-day follow-up was the criterion standard when I 1 D was not performed. Results: Sixty-four of 107 patients had I 1 D-proven abscess, 17 of 107 had negative I 1 D, and 26 of 107 improved with antibiotic therapy alone. The sensitivity of clinical examination for abscesses was 86% (95% confidence interval [CI] = 76% to 93%), and the specificity was 70% (95% CI = 55% to 82%). The positive predictive value was 81% (95% CI = 70% to 90%), and the negative predictive value was 77% (95% CI = 62% to 88%). The sensitivity of US for abscess was 98% (95% CI = 93% to 100%), and the specificity was 88% (95% CI = 76% to 96%). The positive predictive value was 93% (95% CI = 84% to 97%), and the negative predictive value was 97% (95% CI = 88% to 100%). Of 18 cases in which US disagreed with the clinical examination, US was correct in 17 (94% of cases with disagreement, x 2 = 14.2, p = 0.0002). Conclusions: ED bedside US improves accuracy in detection of superficial abscesses.

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“…If the signal has zero mean (i.e., is nondirectional), it is noise. Some of the multiple differential diagnoses causing heel pain may also lead to hyperemia (e.g., inflammatory arthritis) (Walther et al 2001(Walther et al , 2002, fracture (Rawool et al 2003), tumor (Brown et al 1998) or infection (Arslan et al 1998). However, the clinical condition of the patient, as well as the location of the hyperemia, normally allow a final diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Power Doppler findings in plantar fasciitis

Walther

Radke

Kirschner

et al. 2004

Ultrasound in Medicine & Biology

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The role of power Doppler sonography in the evaluation of superficial soft tissue abscesses

Cited by 50 publications

References 7 publications

The vascularity of internal fistulae in Crohn's disease: an in vivo power Doppler ultrasonography assessment

The vascularity of internal fistulae in Crohn's disease: an in vivo power Doppler ultrasonography assessment

ABSCESS: Applied Bedside Sonography for Convenient Evaluation of Superficial Soft Tissue Infections

Power Doppler findings in plantar fasciitis

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