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IMO 1211 Color Doppler ultrasound “pulmonary artery vessel signal”: A sign for diagnosing the benign lesions
INTERNAL
IMO 1211 COLOR VESSEL LESIONS Wu-Huei Diiision Taichung
DOPPLER SIGNAL
ULTRASOUND ” : A SIGN FOR
“ PULMONARY DIAGNOSING
ARTERY THE BENIGN
Hsu, Chi-Der Chiang, Jeng-Yuan Hsu. of Chest Medicine, Department of Internal Medicine, Veterans General Hospital, Taichung, Taiwan.
Based on the findings of lung cancer blood supply originated from the bronchial artery, the characteristics of angiography can differentiate lung cancers from benign lesions. Thus, if vessel signals within pulmonary lesions can be confirmed to be pulmonary arteries by color Doppler ultrasound (US), color Doppler US should be able to diagnose the benign lesions. One hundred and eighty-nine patients with abutting thoracic lesions (including 112 lung cancers and 77 benign lesions) underwent color Doppler US examinations. All color Doppler US vessel signals with spectral waveform analysis were recorded on colorprinted sonopapers and/or laser disc. A pulsatile flow, with the vessel signal length t 1 cm demonstrated by color Doppler US, was arbitrarily defined as a “ pulmonary artery vessel signal ” (The pulsatile flow vessel signals within lung cancers, presenting as torturous, small, and irregular, can not be well demonstrated by color Doppler US smoothly). Among the enrolled 189 thoracic lesions, sixty-four lung cancers and 56 benign lesions had the detectable color Doppler US pulsatile flow vessel signals. Analyzing the pulsatile flow vessel signals. color Doppler US “ pulmonary artery vessel signal ” is only present in 33 benign lesions and is not found in all lung cancers. Using the “ pulmonary artery vessel signal ” sign, color Doppler US is valuable to diagnose and differentiate benign lesions from lung cancers ( p < 0.0001, sensitivity=0.43, and specificity=1 .O). We conclude that color Doppler US ‘I pulmonary artery vessel signal ” provides a simple. convenient, and useful imaging method to diagnose the benign lesions, with high specificity and without any risk.
IMO 1212 COLOR PORTAL ARTERY.
DOPPLER VENOUS
SONOGRAPHY SYSTEM AND
OF THE HEPATIC
R. P&ez Arangiiena, R. Gonzalez Costero, T. Fontanilla Echeveste, B. Brea Lbpez., D. L6pez Santander,M. Martin lzquierdo,J. MarcosL6pez. Servicios de Radiodiagnostico.Clinica Puerta de Hierro.UniversidadAutbnomaMadrid. Introduction: Ultrasound(US) for evaluationof the portal venoussystemhasbecomemorefrequentasthe use of liver transplantationand portosystemicshunt creationhas increased.Proper interpretationof these imagingrequiresfamiliarity with flow variants.One of themostimportantof thesevariantsishelicalflow. Purpose:To study: a) morphologicalchangesin the portalvein, b) flow direction(hepatopetal,hepatofbgal, bidirectional,helical)andvelocity in the portal venous system,c) abnormalhepaticarterialflow. MaterialsandMethods:We analyzed125patientswith or without clinicaVUSevidenceof liver disease(focal or diffuse)who underwentabdominalsonography with gray-scaleimagesandcolor Dopplerequipment. Results:Findingsin the 125examinations included:1) normalflow patterns,2) portal venousthrombosis3) portosystemicand portoportalcollaterals4) abnormal flow patterns5) associated changesin hepaticarterial flow.
MEDICINE
S23
IMO 1214 COLOR-FILLED PATTERN IN HEPATOCELLULAR CARCINOMA Sachiko Tanaka, Tsugio Kitamra, Fumi Yoshioka The Osaka Medical Center for Cancer & Cardiovascular Diseases, Osaka, Japan Contrast enhanced color Doppler sonograms with Levovist was performed on a total of 30 liver tumors including 21 HCCs. A “colorfilIed pattern”, which defines an image of a tumor area filled with color in contrast to the surrounding liver, appeared in 67% of HCCs about 10 sec. after the enhancement of tumor vessel. This finding could not be observed in 9 other tumors. The detectability of a “feeding artery” also increased from 43% to 95% of HCCs after contrast enhancement. A “feeding artery” is more sensitive than a “color-filled pattern” for the diagnosis of HCC. However, it requires time, technical skill and triplex function of the equipment, to detect a fine “feeding artery”. While the sensitivity of the finding of a “color-filled pattern” is not so high, it is useful because of the high specificity and the accessibility of detection.
IMO 1215 3-D IMAGE OF TUMOR BLOOD FLOWS IN HCC WITH POWER MODE DOPPLER SONOGRAPHY Sachiko Tanaka, Tsugio Kitamra, osamu oshikawa The Osaka Medical Center for Cancer & Cardiovascular Diseases, Osaka, Japan As the characteristic color Doppler findings of HCC, we have reported a Basket pattern with tumor vessels; feeding artery and draining portal vein. However, visualizing the whole image of the blood flows of a tumor on a single tomogram is impossible. In this report, the advantage of 3-D (three dimensional) image of tumor blood flows in HCC with power mode Doppler sonography is presented. Equipment used is HDI-3000 (ATL, Botthel) . It took about 10 sec. for recording and one min. for reconstruction of 3-D. 3-D image was effective for understanding total image of tumor blood flows, including basket pattern, feeders and dl-ainS. When we used 4-2 MHz convex probe, the findings could have been well compared with those of hepatic angiography. And the 3-D with 10-S MHz linear probe could visualize more detailed tumor blood flows than by hepatic angiography.
IMO 1211 COLOR VESSEL LESIONS Wu-Huei Diiision Taichung
DOPPLER SIGNAL
ULTRASOUND ” : A SIGN FOR
“ PULMONARY DIAGNOSING
ARTERY THE BENIGN
Hsu, Chi-Der Chiang, Jeng-Yuan Hsu. of Chest Medicine, Department of Internal Medicine, Veterans General Hospital, Taichung, Taiwan.
Based on the findings of lung cancer blood supply originated from the bronchial artery, the characteristics of angiography can differentiate lung cancers from benign lesions. Thus, if vessel signals within pulmonary lesions can be confirmed to be pulmonary arteries by color Doppler ultrasound (US), color Doppler US should be able to diagnose the benign lesions. One hundred and eighty-nine patients with abutting thoracic lesions (including 112 lung cancers and 77 benign lesions) underwent color Doppler US examinations. All color Doppler US vessel signals with spectral waveform analysis were recorded on colorprinted sonopapers and/or laser disc. A pulsatile flow, with the vessel signal length t 1 cm demonstrated by color Doppler US, was arbitrarily defined as a “ pulmonary artery vessel signal ” (The pulsatile flow vessel signals within lung cancers, presenting as torturous, small, and irregular, can not be well demonstrated by color Doppler US smoothly). Among the enrolled 189 thoracic lesions, sixty-four lung cancers and 56 benign lesions had the detectable color Doppler US pulsatile flow vessel signals. Analyzing the pulsatile flow vessel signals. color Doppler US “ pulmonary artery vessel signal ” is only present in 33 benign lesions and is not found in all lung cancers. Using the “ pulmonary artery vessel signal ” sign, color Doppler US is valuable to diagnose and differentiate benign lesions from lung cancers ( p < 0.0001, sensitivity=0.43, and specificity=1 .O). We conclude that color Doppler US ‘I pulmonary artery vessel signal ” provides a simple. convenient, and useful imaging method to diagnose the benign lesions, with high specificity and without any risk.
IMO 1212 COLOR PORTAL ARTERY.
DOPPLER VENOUS
SONOGRAPHY SYSTEM AND
OF THE HEPATIC
R. P&ez Arangiiena, R. Gonzalez Costero, T. Fontanilla Echeveste, B. Brea Lbpez., D. L6pez Santander,M. Martin lzquierdo,J. MarcosL6pez. Servicios de Radiodiagnostico.Clinica Puerta de Hierro.UniversidadAutbnomaMadrid. Introduction: Ultrasound(US) for evaluationof the portal venoussystemhasbecomemorefrequentasthe use of liver transplantationand portosystemicshunt creationhas increased.Proper interpretationof these imagingrequiresfamiliarity with flow variants.One of themostimportantof thesevariantsishelicalflow. Purpose:To study: a) morphologicalchangesin the portalvein, b) flow direction(hepatopetal,hepatofbgal, bidirectional,helical)andvelocity in the portal venous system,c) abnormalhepaticarterialflow. MaterialsandMethods:We analyzed125patientswith or without clinicaVUSevidenceof liver disease(focal or diffuse)who underwentabdominalsonography with gray-scaleimagesandcolor Dopplerequipment. Results:Findingsin the 125examinations included:1) normalflow patterns,2) portal venousthrombosis3) portosystemicand portoportalcollaterals4) abnormal flow patterns5) associated changesin hepaticarterial flow.
MEDICINE
S23
IMO 1214 COLOR-FILLED PATTERN IN HEPATOCELLULAR CARCINOMA Sachiko Tanaka, Tsugio Kitamra, Fumi Yoshioka The Osaka Medical Center for Cancer & Cardiovascular Diseases, Osaka, Japan Contrast enhanced color Doppler sonograms with Levovist was performed on a total of 30 liver tumors including 21 HCCs. A “colorfilIed pattern”, which defines an image of a tumor area filled with color in contrast to the surrounding liver, appeared in 67% of HCCs about 10 sec. after the enhancement of tumor vessel. This finding could not be observed in 9 other tumors. The detectability of a “feeding artery” also increased from 43% to 95% of HCCs after contrast enhancement. A “feeding artery” is more sensitive than a “color-filled pattern” for the diagnosis of HCC. However, it requires time, technical skill and triplex function of the equipment, to detect a fine “feeding artery”. While the sensitivity of the finding of a “color-filled pattern” is not so high, it is useful because of the high specificity and the accessibility of detection.
IMO 1215 3-D IMAGE OF TUMOR BLOOD FLOWS IN HCC WITH POWER MODE DOPPLER SONOGRAPHY Sachiko Tanaka, Tsugio Kitamra, osamu oshikawa The Osaka Medical Center for Cancer & Cardiovascular Diseases, Osaka, Japan As the characteristic color Doppler findings of HCC, we have reported a Basket pattern with tumor vessels; feeding artery and draining portal vein. However, visualizing the whole image of the blood flows of a tumor on a single tomogram is impossible. In this report, the advantage of 3-D (three dimensional) image of tumor blood flows in HCC with power mode Doppler sonography is presented. Equipment used is HDI-3000 (ATL, Botthel) . It took about 10 sec. for recording and one min. for reconstruction of 3-D. 3-D image was effective for understanding total image of tumor blood flows, including basket pattern, feeders and dl-ainS. When we used 4-2 MHz convex probe, the findings could have been well compared with those of hepatic angiography. And the 3-D with 10-S MHz linear probe could visualize more detailed tumor blood flows than by hepatic angiography.