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Xu Y, Zhu XY, Feng H, Yu XP, Wang Y, Rong X, Qi TY. The value of quantitative contrast-enhanced ultrasonography analysis in evaluating central retinal artery microcirculation in patients with diabetes mellitus: comparison with colour Doppler imaging. Clin Radiol 2024; 79:e560-e566. [PMID: 38336532 DOI: 10.1016/j.crad.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/12/2023] [Accepted: 01/12/2024] [Indexed: 02/12/2024]
Abstract
AIM To compare the efficacy of quantitative contrast-enhanced ultrasonography (CEUS) analysis and colour Doppler ultrasound (CDU) in evaluating central retinal artery (CRA) microcirculation in patients with diabetes mellitus (DM). MATERIALS AND METHODS In this prospective study, a total of 55 patients (98 eyes) with DM were enrolled as the study group. They were compared to 46 age-matched healthy volunteers (92 eyes) who were selected as the control group. Each patient underwent CDU and subsequent CEUS examination. CDU and quantitative CEUS parameters were evaluated. The diagnostic efficiency of the diagnostic performance of CEUS and CDU was evaluated and compared, and the scale thresholds of predictive indicators for the diagnosis of proliferative diabetic retinopathy (PDR) were evaluated using receiver operating characteristics (ROC) curve analyses. RESULTS Group pairwise comparisons showed that the end diastolic velocity (EDV) and arrival time (AT) of CRA were significant predictors for PDR by CDU and by quantitative CEUS analysis, respectively (all p<0.05). The ROC curve analysis showed that the area under the curve value of AT was significantly higher than that of EDV (0.875 versus 0.634, p=0.0002). Accordingly, an AT cut-off value of 1.07 seconds resulted a sensitivity of 90.62 % and a specificity of 79.31 %. CONCLUSION Quantitative CEUS analysis can improve the accuracy of clinical staging of diabetic retinopathy for the patients with DM, and the AT showed the best diagnostic efficiency.
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Affiliation(s)
- Y Xu
- Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225012, China
| | - X Y Zhu
- Department of Ophthalmology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225012, China
| | - H Feng
- Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225012, China
| | - X P Yu
- Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225012, China
| | - Y Wang
- Department of Ophthalmology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225012, China
| | - X Rong
- Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225012, China
| | - T Y Qi
- Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225012, China.
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Lei S, Zhang C, Zhu B, Gao Z, Zhang Q, Liu J, Li Y, Zheng H, Ma T. In vivo ocular microvasculature imaging in rabbits with 3D ultrasound localization microscopy. ULTRASONICS 2023; 133:107022. [PMID: 37178486 DOI: 10.1016/j.ultras.2023.107022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/15/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023]
Abstract
Morphological and hemodynamic changes in the ocular vasculature are important signs of various ocular diseases. The evaluation of the ocular microvasculature with high resolution is valuable in comprehensive diagnoses. However, it is difficult for current optical imaging techniques to visualize the posterior segment and retrobulbar microvasculature due to the limited penetration depth of light, particularly when the refractive medium is opaque. Thus, we have developed a 3D ultrasound localization microscopy (ULM) imaging method to visualize the ocular microvasculature in rabbits with micron-scale resolution. We used a 32 × 32 matrix array transducer (center frequency: 8 MHz) with a compounding plane wave sequence and microbubbles. Block-wise singular value decomposition spatiotemporal clutter filtering and block-matching 3D denoising were implemented to extract the flowing microbubble signals at different imaging depths with high signal-to-noise ratios. The center points of microbubbles were localized and tracked in 3D space to achieve the micro-angiography. The in vivo results demonstrate the ability of 3D ULM to visualize the microvasculature of the eye in rabbits, where vessels down to 54 μm were successfully revealed. Moreover, the microvascular maps indicated the morphological abnormalities in the eye with retinal detachment. This efficient modality shows potential for use in the diagnosis of ocular diseases.
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Affiliation(s)
- Shuang Lei
- School of Optical and Electronic Information, Huazhong University of Science and Technology, Wuhan 430074, China; Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Changlu Zhang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Benpeng Zhu
- School of Optical and Electronic Information, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Zeping Gao
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Qi Zhang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; National Innovation Center for Advanced Medical Devices, Shenzhen 518126, China
| | - Jiamei Liu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; National Innovation Center for Advanced Medical Devices, Shenzhen 518126, China
| | - Yongchuan Li
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Hairong Zheng
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Teng Ma
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; National Innovation Center for Advanced Medical Devices, Shenzhen 518126, China.
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Zhang Y, Deng Q, Sun B, Chen L, Huang X, Pan J, Huang X, Zhang J, Chen W. Differentiation of Malignant and Benign Orbital Space-Occupying Lesions Using Contrast-Enhanced Ultrasound: Added Value From a Time-Intensity Curve-Based Quantitative Analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:2477-2486. [PMID: 33470432 DOI: 10.1002/jum.15636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/23/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To evaluate the value of time-intensity curve (TIC) analysis of contrast-enhanced ultrasound (CEUS) signal to differentiate malignant from benign orbital space-occupying lesions. METHODS The CEUS signal of 111 patients with orbital space-occupying lesions was retrospectively analyzed using SonoLiver software. TIC-related parameters such as the arrival time (AT), rise time (RT), time to peak (TTP), maximum intensity (IMAX), mean transit time (mTT), slope of the increase (RS), and slope of the decrease (DS) were compared between the malignant and benign groups. Receiver operating characteristic (ROC) curve analysis was used to acquire the cutoff values of these parameters for differential diagnosis. RESULTS TIC patterns were characterized by fast increase and fast decrease in signal intensity in the malignant group, fast increase and a slow decrease in signal intensity in the benign group. The differences in the IMAX, RS, DS, mTT, TTP, and RT between the 2 groups were statistically significant (p <.01), while the difference in the AT were not (p = .672). ROC curve analysis showed that IMAX = 427.20, DS = 34.72, and mTT = 33.55 were the best cutoff values for differential diagnosis of malignant and benign space-occupying lesions. The accuracy rate of CEUS visual evaluation for differential diagnosis was 66.67% (74/111), while TIC quantitative analysis could effectively improve the accuracy to 89.19% (99/111). CONCLUSIONS TIC analysis can improve CEUS efficiency to differentiate malignant from benign orbital space-occupying lesions.
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Affiliation(s)
- Yao Zhang
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Qing Deng
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Bin Sun
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Liao Chen
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xin Huang
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Juhong Pan
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xingyue Huang
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jun Zhang
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Wenwei Chen
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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Rousou C, Schuurmans CCL, Urtti A, Mastrobattista E, Storm G, Moonen C, Kaarniranta K, Deckers R. Ultrasound and Microbubbles for the Treatment of Ocular Diseases: From Preclinical Research towards Clinical Application. Pharmaceutics 2021; 13:pharmaceutics13111782. [PMID: 34834196 PMCID: PMC8624665 DOI: 10.3390/pharmaceutics13111782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 12/26/2022] Open
Abstract
The unique anatomy of the eye and the presence of various biological barriers make efficacious ocular drug delivery challenging, particularly in the treatment of posterior eye diseases. This review focuses on the combination of ultrasound and microbubbles (USMB) as a minimally invasive method to improve the efficacy and targeting of ocular drug delivery. An extensive overview is given of the in vitro and in vivo studies investigating the mechanical effects of ultrasound-driven microbubbles aiming to: (i) temporarily disrupt the blood–retina barrier in order to enhance the delivery of systemically administered drugs into the eye, (ii) induce intracellular uptake of anticancer drugs and macromolecules and (iii) achieve targeted delivery of genes, for the treatment of ocular malignancies and degenerative diseases. Finally, the safety and tolerability aspects of USMB, essential for the translation of USMB to the clinic, are discussed.
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Affiliation(s)
- Charis Rousou
- Departments of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584 CS Utrecht, The Netherlands; (C.C.L.S.); (E.M.); (G.S.)
- Division of Imaging and Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; (C.M.); (R.D.)
- Correspondence:
| | - Carl C. L. Schuurmans
- Departments of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584 CS Utrecht, The Netherlands; (C.C.L.S.); (E.M.); (G.S.)
- Department of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584 CS Utrecht, The Netherlands
| | - Arto Urtti
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70210 Kuopio, Finland;
- Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, P.O. Box 56, 00014 Helsinki, Finland
- Institute of Chemistry, St. Petersburg State University, Universitetskii Pr. 26, Petrodvorets, 198504 St. Petersburg, Russia
| | - Enrico Mastrobattista
- Departments of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584 CS Utrecht, The Netherlands; (C.C.L.S.); (E.M.); (G.S.)
| | - Gert Storm
- Departments of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584 CS Utrecht, The Netherlands; (C.C.L.S.); (E.M.); (G.S.)
- Department of Biomaterials Science and Technology, University of Twente, 7500 AE Enschede, The Netherlands
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Chrit Moonen
- Division of Imaging and Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; (C.M.); (R.D.)
| | - Kai Kaarniranta
- Department of Ophthalmology, Kuopio University Hospital, P.O. Box 100, 70029 Kuopio, Finland;
- Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Roel Deckers
- Division of Imaging and Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; (C.M.); (R.D.)
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In memoriam: Dr. Giovanni Serafini, MD. J Ultrasound 2020. [DOI: 10.1007/s40477-020-00459-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Blohm KO, Tichy A, Nell B. Clinical utility, dose determination, and safety of ocular contrast-enhanced ultrasonography in horses: A pilot study. Vet Ophthalmol 2019; 23:331-340. [PMID: 31799804 PMCID: PMC7155076 DOI: 10.1111/vop.12730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/21/2019] [Accepted: 11/08/2019] [Indexed: 12/29/2022]
Abstract
Objective To determine efficacy of contrast‐enhanced ultrasonography (CEUS) using different sulfur hexafluoride (SF6) doses to assess blood flow and perfusion in equine eyes and to evaluate safety of SF6 in horses. Procedures Ocular B‐mode and contrast‐enhanced ultrasonography were performed bilaterally in nine sedated university‐owned horses. Intravenous SonoVue® bolus injections of 5, 10, 15, 20, 25, and 30 mL were administered for 2/18, 5/18, 6/18, 3/18, 1/18, and 1/18 eyes, respectively. Doses were increased based on ascending bodyweight. Each eye within one horse was examined utilizing a different dose. Qualitative blood flow and quantitative perfusion were analyzed. Heart and respiratory rates were monitored nonsedated, sedated, and during first and second minutes of CEUS. Results Qualitative contrast enhancement (CE) was visible in 7/9 animals. Quantitative CE was measurable bilaterally in four horses, unilaterally in three individuals, and not detected in two animals. In all horses with unilateral CE, the positive eye received the higher dose. Fifteen mL dose resulted in significantly shorter time to peak than 10 mL (P < .05). Peak intensity, maximum signal increase, and corresponding area under the curve were significantly higher for 15 and 20 mL doses compared with 10 mL (P < .05). Uveal and retinal tissues were enhanced frequently. Twenty‐five and 30 mL doses revealed no CE. Only sedation reduced heart rates significantly (P < .05). Clinically relevant changes in respiratory rates or adverse reactions following SF6 application were not observed. Conclusions Contrast enhancement was in most instances dose‐dependent. Fifteen mL appeared appropriate to assess equine ocular perfusion. The reliability in horses remains questionable; however, CEUS was well‐tolerated.
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Affiliation(s)
- Klaas-Ole Blohm
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Alexander Tichy
- Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Barbara Nell
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
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Blohm KO, Hittmair KM, Tichy A, Nell B. Quantitative, noninvasive assessment of intra- and extraocular perfusion by contrast-enhanced ultrasonography and its clinical applicability in healthy dogs. Vet Ophthalmol 2019; 22:767-777. [PMID: 30773789 PMCID: PMC6899557 DOI: 10.1111/vop.12648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/02/2018] [Accepted: 01/02/2019] [Indexed: 11/30/2022]
Abstract
Objective To assess quantitative perfusion of intra‐ and extraocular regions of interest (ROIs) in conscious, healthy dogs utilizing contrast‐enhanced ultrasonography (CEUS); to compare varying enhancement with the first and second bolus injection and in the right and left eye; and to determine the most appropriate examination time. Procedures Gray scale ultrasonography and contrast harmonic imaging using sulfur hexafluoride were performed randomly assigned in both eyes in 10 university‐owned beagles. Perfusion parameters including slope time, time to peak (TTP), peak intensity (PI), and area under the curve (AUC) were measured at individually drawn ROIs (retrobulbar cone = ROI 1, choroid‐retina complex = ROI 2, medial = ROI 3, and lateral anterior uvea = ROI 4). Results Time‐intensity curve parameters revealed no significant differences in eyes examined by the first or second bolus injection (P > 0.05) or in the right or left eye (P > 0.05). Pooled data from all eyes were analyzed. Peak intensity of ROI 2 was significantly higher compared to all other ROIs (P < 0.001). Area under the curve at ROI 2 was significantly higher compared to all other ROIs (P < 0.05), and AUC at ROI 1 was significantly higher than at ROI 4 (P < 0.05). No significant differences in TTP were observed between different ROIs (P > 0.05). Ratios relative to different ROI sizes showed fastest enhancement in the retrobulbar cone and most intense perfusion in the anterior uveal regions. The first minute after contrast injection provided the highest diagnostic value. Conclusion Quantitative perfusion in nondiseased canine eyes revealed consistent parameters. Application of standardized CEUS protocols may be a promising diagnostic tool to differentiate ocular lesions.
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Affiliation(s)
- Klaas-Ole Blohm
- Department for Companion Animals and Horses, Ophthalmology Service, University of Veterinary Medicine, Vienna, Austria
| | - Katharina M Hittmair
- Department for Companion Animals and Horses, Diagnostic Imaging, University of Veterinary Medicine, Vienna, Austria
| | - Alexander Tichy
- Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Barbara Nell
- Department for Companion Animals and Horses, Ophthalmology Service, University of Veterinary Medicine, Vienna, Austria
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Yan L, He G, Zhou X, Zheng Y, Zhu Y, Yang J, Zhang M, Zhou Y. Contrast-enhanced ultrasound in the diagnosis of orbital space-occupying lesions. Clin Radiol 2017; 72:798.e1-798.e6. [PMID: 28464984 DOI: 10.1016/j.crad.2017.03.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/22/2017] [Accepted: 03/30/2017] [Indexed: 12/29/2022]
Abstract
AIM To summarise the sonographic findings and assess the feasibility of contrast-enhanced ultrasound (CEUS) as an imaging method for the diagnosis of orbital space-occupying lesions. MATERIALS AND METHODS This was a prospective study of 53 patients who underwent orbital ultrasound at Xijing Hospital. Two-dimensional ultrasound, colour Doppler flow imaging (CDFI), and CEUS imaging were obtained and compared in patients with orbital haemangioma, pseudotumour, melanoma of the choroid, and retinoblastoma. RESULTS CEUS imaging cannot only visualise the location, shape, border, acoustic properties of a lesion, and interactions between the lesion and surrounding tissues, but also display the microvasculature and tissue perfusion within the lesion. The information obtained from CEUS imaging is valuable for diagnosis and differential diagnosis of orbital space-occupying lesions. CONCLUSION CEUS imaging allowed better visualisation of the lesions, enabled detection of vascular changes, increased the signal-to-noise ratio, and increased the sensitivity of detection of changes in perfusion in the microcirculation. It has relatively high sensitivity and specificity in the diagnosis of orbital space-occupying lesions and increases the accuracy of diagnosis.
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Affiliation(s)
- L Yan
- Department of Ultrasonography, Xijing Hospital, The Fourth Military Medical University, No. 17 West Changle Road, Xi'an 710032, China; Department of Ultrasonography, Xi'an Central Hospital, The Third Affiliated Hospital of JiaoTong University, No. 185 Houzai Gate, Xi'an 710003, China
| | - G He
- Department of Ultrasonography, Xijing Hospital, The Fourth Military Medical University, No. 17 West Changle Road, Xi'an 710032, China
| | - X Zhou
- Department of Ultrasonography, Xijing Hospital, The Fourth Military Medical University, No. 17 West Changle Road, Xi'an 710032, China.
| | - Y Zheng
- Department of Ultrasonography, Xi'an Central Hospital, The Third Affiliated Hospital of JiaoTong University, No. 185 Houzai Gate, Xi'an 710003, China
| | - Y Zhu
- Department of Ultrasonography, Xi'an Central Hospital, The Third Affiliated Hospital of JiaoTong University, No. 185 Houzai Gate, Xi'an 710003, China
| | - J Yang
- Department of CT & MRI, Xi'an Central Hospital, The Third Affiliated Hospital of JiaoTong University, No. 185 Houzai Gate, Xi'an 710003, China
| | - M Zhang
- Department of Ultrasonography, Xijing Hospital, The Fourth Military Medical University, No. 17 West Changle Road, Xi'an 710032, China
| | - Y Zhou
- Department of Ultrasonography, Xi'an Central Hospital, The Third Affiliated Hospital of JiaoTong University, No. 185 Houzai Gate, Xi'an 710003, China
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Bakhda RN. Specialized Diagnostic Investigations to Assess Ocular Status in Hypertensive Diseases of Pregnancy. Diseases 2016; 4:diseases4020019. [PMID: 28933399 PMCID: PMC5456274 DOI: 10.3390/diseases4020019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 03/27/2016] [Accepted: 04/15/2016] [Indexed: 11/16/2022] Open
Abstract
This review describes specialized diagnostic investigations to assess ocular status in hypertensive diseases of pregnancy. Ocular assessment can aid in early detection for prompt multidisciplinary treatment, obstetric intervention and follow-up. The investigations accurately predict the possible causes of blindness in hypertensive diseases of pregnancy. The investigations include fluorescein angiography, ophthalmodynamometry, fluorophotometry, imaging modalities, OCT, ultrasonography, doppler velocimetry and blood chemistry analysis. The review includes a summary of imaging techniques and related recent developments to assess the neuro-ophthalmic aspects of the disease. The imaging modalities have been instrumental in understanding the complex neuropathophysiological mechanisms of eclamptic seizures. The importance of blood chemistry analysis in hypertensive diseases of pregnancy has been emphasized. The investigations have made a significant contribution in improving the standards of antenatal care and reducing maternal and fetal morbidity and mortality.
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Affiliation(s)
- Rahul Navinchandra Bakhda
- Consultant Ophthalmologist, Ex-Resident, M & J Western Regional Institute of Ophthalmology, Ahmedabad 380016, Gujarat, India.
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Hau SC, Papastefanou V, Shah S, Sagoo MS, Restori M, Cohen V. Evaluation of iris and iridociliary body lesions with anterior segment optical coherence tomography versus ultrasound B-scan. Br J Ophthalmol 2014; 99:81-6. [PMID: 25091953 PMCID: PMC4283679 DOI: 10.1136/bjophthalmol-2014-305218] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Aims To compare anterior segment optical coherence tomography (AS-OCT) with ultrasound B-scan (USB) in evaluating iris and iridociliary body lesions. Methods Image features and resolution comparison between AS-OCT and USB in 126 patients (126 eyes) presenting with iris or iridociliary body lesion. Bland–Altman plots were generated to assess the level of agreement between the two techniques. Results The three most common diagnoses were iris naevi (62 (49.2%)), iris pigment epithelial cysts (23 (18.3%)) and iris melanoma (11 (8.7%)). Image feature comparison for USB was better than AS-OCT in visualising all tumour margins (81 (64.3%) vs 59 (46.8%)), posterior tumour margin (54 (42.9%) vs 16 (12.7%)) and producing less posterior shadowing (121 (96%) vs 43 (34.1%)). Image resolution comparison revealed USB to be slightly better for resolving the overall tumour (45 (35.7%) vs 43 (34.1%)) and posterior tumour surface (70 (55.6%) vs 32 (25.4%)) but AS-OCT was better for resolving the anterior (62 (49.2%) vs 4 (3.2%)) and lateral tumour surface (62 (49.2%) vs 31 (24.6%)). Comparing the three most common diagnoses, USB was better for visualising iris pigment epithelial cysts (12 (52.2%) vs 2 (8.7%)) and iris melanoma (7 (63.6%) vs 1 (9.1%)) but AS-OCT was better (28 (45.2%) vs 15 (24.2%)) for visualising iris naevi. Bland–Altman plots showed good agreement between the two techniques for lesions smaller than 3 mm in base and 2 mm in elevation. Conclusions AS-OCT is superior to USB for imaging small lesions pertaining to the anterior iris but USB is better for imaging larger iris lesions with posterior or ciliary body extension.
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Affiliation(s)
- Scott C Hau
- NIHR Biomedical Research Centre in Ophthalmology Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Vasilios Papastefanou
- NIHR Biomedical Research Centre in Ophthalmology Moorfields Eye Hospital NHS Foundation Trust, London, UK Ocular Oncology Service, St. Bartholomew's Hospital, London, UK
| | - Shima Shah
- NIHR Biomedical Research Centre in Ophthalmology Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Mandeep S Sagoo
- NIHR Biomedical Research Centre in Ophthalmology Moorfields Eye Hospital NHS Foundation Trust, London, UK Ocular Oncology Service, St. Bartholomew's Hospital, London, UK UCL Institute of Ophthalmology, London, UK
| | - Marie Restori
- NIHR Biomedical Research Centre in Ophthalmology Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Victoria Cohen
- NIHR Biomedical Research Centre in Ophthalmology Moorfields Eye Hospital NHS Foundation Trust, London, UK Ocular Oncology Service, St. Bartholomew's Hospital, London, UK
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Orlandi D, Sconfienza LM, Lacelli F, Bertolotto M, Sola S, Mauri G, Savarino E, Serafini G. Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions. Eur Radiol 2013; 23:1919-24. [DOI: 10.1007/s00330-013-2776-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 12/15/2012] [Accepted: 12/19/2012] [Indexed: 12/26/2022]
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