OBJECTIVE: To compare fetal pulmonary artery Doppler parameters between pregnant women with asthma and healthy pregnant women.
METHODS: This prospective, cross-sectional study was conducted on 50 pregnant women diagnosed with asthma and 61 healthy pregnant women. Fetal pulmonary artery Doppler parameters and the fetal main pulmonary artery acceleration time/ejection time (PATET) ratio were compared between the study and control groups. Thereafter, the study group was divided into two subgroups as non-severe and severe asthma. PATET ratio was compared between the subgroups.
RESULTS: The fetal main pulmonary artery acceleration time was 25 ms in pregnant women with asthma and 33 ms in the healthy group, indicating a statistically significant difference (p=0.001). The acceleration time/ejection time ratio was statistically lower in the asthma group (0.185 vs. 0.240, p<0.001). The acceleration time/ejection time ratio was 0.172 in patients with severe asthma and 0.195 ms in the non-severe study group (p=0.156). In the maternal asthma group, the PATET ratio of those who went to the NICU due to respiratory distress was also 0.188, and the PATET ratio of those who went to the NICU for other reasons was 0.269 (p=0.053).
CONCLUSIONS: Fetal pulmonary artery acceleration time and PATET decreased statistically in pregnant women with severe or non-severe asthma. Maternal asthma is associated with changes in pulmonary Doppler parameters in the fetus.

Background and Objectives: Patellar tendinopathy is difficult to treat, and when combined with partial rupture, there are additional challenges. The aim of this study was to evaluate the subjective outcome and return-to-sport status after ultrasound (US)- and colour doppler (CD)-guided wide awake local anaesthetic no tourniquet (WALANT) arthroscopic shaving in elite athletes. Material and Methods: Thirty Swedish and international elite athletes (27 males) with a long duration (>1 year) of persistent painful patellar tendinopathy in 35 patellar tendons, not responding to non-surgical treatment, were included. All patients were treated with the same protocol of arthroscopic shaving, including bone removal and debridement of partial rupture, followed by at least 3 months of structured rehabilitation. The VISA-P score and a study-specific questionnaire evaluating physical activity level and subjective satisfaction with the treatment were used for evaluation. Results: At the 2-year follow-up (mean 23, range 8-38 months), 25/30 patients (29/35 tendons) were satisfied with the treatment result and had returned to their pre-injury sport. The mean VISA-P score increased from 37 (range 7-69) before surgery to 80 (range 44-100) after surgery (p < 0.05). There was one drop-out (one tendon). There were no complications. Conclusions: US- and CD-guided WALANT arthroscopic shaving for persistent painful patellar tendinopathy, including bone removal and debridement of partial rupture, followed by structured rehabilitation showed good clinical results in the majority of the elite-level athletes.

OBJECTIVE: This case series aims to provide a comprehensive description of the utilization of doppler ultrasonography (USG) and computerized tomography angiography (CTA) in evaluating patients with earthquake-induced crush injuries in the emergency department (ED).
METHODS: This retrospective case series was conducted on 11 patients who presented with crush injuries following a seismic event. These patients underwent initial assessment using doppler USG, with CTA performed when deemed necessary. Clinical outcomes and diagnostic findings were systematically reviewed.
RESULTS: A cohort of 11 earthquake-related crush injury patients (six females, five males; age 3-59 years), predominantly with lower extremity injuries, with entrapped durations that ranged from 12 to 128 hours. Transport centers received patients from both affected regions and nearby provinces. Initial X-rays identified fractures in two cases. Doppler USG and subsequent CTA were employed for vascular evaluation, with CTA confirming doppler USG findings. Of the 11 patients, five exhibited abnormal doppler USG findings. Four patients required dialysis and four underwent amputation surgery. Fasciotomy and debridement procedures were performed in five and seven patients, respectively. Three patients received hyperbaric oxygen therapy (HBOT).
CONCLUSIONS: Doppler USG emerged as a dependable tool for assessing vascular injuries in earthquake-related crush injuries, offering an effective alternative to CTA without the associated contrast agent risks. These findings underscore the need for further research to establish definitive imaging guidelines in these challenging clinical scenarios.

BACKGROUND: We aimed to describe the microvascular features of three types of adult-type diffuse glioma by comparing dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging (MRI) with intraoperative high-frame-rate ultrafast Doppler ultrasound.
METHODS: Case series of seven patients with primary brain tumours underwent both DSC perfusion MRI and intra-operative high-frame-rate ultrafast Doppler ultrasound. From the ultrasound images, three-dimensional vessel segmentation was obtained of the tumour vascular bed. Relative cerebral blood volume (rCBV) maps were generated with leakage correction and normalised to the contralateral normal-appearing white matter. From tumour histograms, median, mean, and maximum rCBV ratios were extracted.
RESULTS: Low-grade gliomas (LGGs) showed lower perfusion than high-grade gliomas (HGGs), as expected. Within the LGG subgroup, oligodendroglioma showed higher perfusion than astrocytoma. In HGG, the median rCBV ratio for glioblastoma was 3.1 while astrocytoma grade 4 showed low perfusion with a median rCBV of 1.2. On the high-frame-rate ultrafast Doppler ultrasound images, all tumours showed a range of rich and organised vascular networks with visually apparent abnormal vessels, even in LGG.
CONCLUSIONS: This unique case series revealed in vivo insights about the microvascular architecture in both LGGs and HGGs. Ultrafast Doppler ultrasound revealed rich vascularisation, also in tumours with low perfusion at DSC MRI. These findings warrant further investigations using advanced MRI postprocessing, in particular for characterising adult-type diffuse glioma.
CONCLUSIONS: Our findings challenge the current assumption behind the estimation of relative cerebral blood volume that the distribution of blood vessels in a voxel is random.
CONCLUSIONS: • Ultrafast Doppler ultrasound revealed rich vascularity irrespective of perfusion dynamic susceptibility contrast MRI state. • Rich and organised vascularisation was also observed even in low-grade glioma. • These findings challenge the assumptions for cerebral blood volume estimation with MRI.

With the Superb Micro-Vascular Imaging (SMI), the established Doppler technology has been extended by another mode. With this technique, microvascular structures with slow blood flow can now also be displayed in real time. As with the introduction of Doppler ultrasound, this new technique opens further diagnostic fields for the examiner, which were previously reserved for magnetic resonance imaging (MRI), computed tomography (CT) or contrast ultrasound (CEUS). Focal nodular hyperplasia (FNH) of the liver is characterized by a typical spoke-wheel vascular malformation (spoke-wheel sign, SWS) anda good example using SMI for the diagnostic profit of our patients. The aim of this report is to describe the use of SMI as a new non-invasive, quick, and probably cost-effective diagnostic imaging tool.

UNASSIGNED: Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder causing abdominal pain, altered bowel habits and bloating without structural issues. Gallbladder dysfunction may be linked to IBS due to disrupted cholecystokinin release. This study aims to assess gallbladder function and related hemodynamic parameters using Doppler ultrasound in IBS before and after meals.
UNASSIGNED: In this case-control study, we investigated gallbladder function differences between constipation-predominant IBS (C-IBS) patients and healthy volunteers. Participants underwent ultrasonography to measure gallbladder parameters before and after consuming a predefined meal. Gallbladder volume, wall thickness and resistance index (RI) of cystic and superior mesenteric arteries (SMA) were assessed. Student t-test and paired t-test were used to compare case and control groups and pre- and post-meal data, respectively.
UNASSIGNED: A total of 34 people (18 C-IBS and 16 healthy control) were included. The mean (Standard deviation) of gallbladder fasting volume was measured 24.74 (8.85) and 29.73 (9.65) cubic millimeter for case and controls, respectively. Postprandial volume was 11.34 (5.66) and 16.9 (6.16) cubic millimeter for case and controls respectively. We observed a statistically significant difference in emptying fractions (EF) between groups (p value = 0.009). IBS patients had a smaller fasting SMA RI (p value = 0.016) but the fraction of change after meal was not significant (p value = 0.10). The cystic artery RI did not reach statistical significance between the fasting and post-meal values (p value = 0.067).
UNASSIGNED: IBS patients have a higher emptying fraction and lower change in SMA RI compared to healthy controls. Further studies with larger sample size, inclusion of patients with different coexisting conditions and subtypes of IBS and combining colon transit study with gallbladder ejection fraction evaluation can be used to further provide more meaning to this study.

OBJECTIVE: To compare the cardiac functions of fetuses with preterm premature rupture of membranes (PPROM) between their control groups and investigate its relationship with perinatal outcomes.
METHODS: This prospective study was conducted with 102 pregnant women. Pregnant women with PPROM were divided into two subgroups Group A, between 26 and 30 weeks, and Group B, between 30 and 34 weeks. A control group was formed by randomly including one healthy pregnant woman for each study patient. Sociodemographic, obstetric data, tissue Doppler imaging, and M-mode imaging results were compared. The relationship between echocardiographic parameters and perinatal outcomes was also investigated.
RESULTS: Tricuspid annular plane systolic excursion (TAPSE), S\', and ET\' of systolic cardiac parameters were shortened in both groups compared with their controls. Diastolic function indicator E\'/A\', and global function indicator myocardial performance index\' increased in both groups. Isovolumetric contraction time\' did not change between groups. A correlation was found between myocardial performance index\', and the length of neonatal intensive care unit stay in Group A and TAPSE and duration of respiratory support and length of neonatal intensive care unit stay in Group B.
CONCLUSIONS: The fetal cardiac function seems to be affected by PPROM, and these changes are associated with neonatal outcomes. Therefore, administering fetal cardiac function evaluation in pregnancies complicated by PPROM may help physicians establish more appropriate clinical management protocols in this special population.

METHODS: Herein we present the case of a 33-year nulliparous woman at 21 weeks of gestation with mitral valve vegetation resulting from infective endocarditis. Due to the mother\'s critical condition caused by consecutive thromboembolic events, surgery with cardiopulmonary bypass was indicated. During surgery the fetus was monitored by a specialized obstetrician who repetitively measured the Doppler indices of the umbilical artery, Ductus venosus and uterine artery. Right after CO2 was insufflated into the operating area, the Doppler monitoring showed an increased Pulsatility Index of the Umbilical artery right before fetal distress with bradycardia occurred. A subsequent maternal arterial blood gas analysis showed an acidosis with hypercapnia. Consequently, the CO2 insufflation was stopped and the gas flow on the Heart Lung Machine increased. After regaining homeostasis of acidosis, the Doppler Indices and fetal heart rate recovered. The remaining surgery and postoperative course were uneventful. At the 37 weeks of gestation a healthy boy was delivered by Cesarean section and at the age of two years, the neurodevelopment was assessed, which indicated normal development in mental cognition, language and motoric. This report presents a periodic Doppler examination of the maternal and fetal circulation during surgery on CPB while also discussing the possible impact of fetal monitoring in managing open cardiac surgery in pregnancy.

UNASSIGNED: Hypertensive disorders of pregnancy (HDP) is associated with an increased risk of adverse outcomes. The fetal middle cerebral artery (MCA) and umbilical artery (UA) blood flow detected by ultrasound are recommended to evaluate the oxygenation of the fetus. It is necessary to analyze the relationship between MCA & UA doppler indices or cerebroplacental ratio (CPR) and fetal outcomes and describe MCA and UA blood flow values across gestation.
UNASSIGNED: Hospital-based retrospective case-control study during 2016 to 2020. 800 singleton pregnant women: 400 normotensive control, 219 gestational hypertension (GH), and 181 preeclampsia (PE)/eclampsia (EC). An analysis of the outcomes of mothers and neonates was performed. The fetal MCA and UA blood flow values across gestation were established, and MCA-resistance index (RI) and CPR were used to predict fetal distress and small for gestational age (SGA).
UNASSIGNED: In the normotensive control, GH and PE/EC groups, the mean gestational age (GA) was 38.9 ± 1.2 weeks, 39.0 ± 1.0 weeks, and 38.6 ± 1.3 weeks respectively, and the mean birth weight (BW) was 3.195 ± 0.387 kilograms, 3.198 ± 0.428 kilograms, and 2.987 ± 0.544 kilograms respectively. There were differences in GA, BW, fetal distress, SGA and intraventricular hemorrhage I-II between the hypertension group and normotensive control group (p < 0.05). The MCA-RI (sensitivity: 70.1%, specificity: 64.3%) and MCA-RI (sensitivity: 52.4%, specificity: 84.6%) were the best indices to predict fetal distress and SGA, respectively during GA of 35-40 weeks.
UNASSIGNED: Fetal MCA blood flow values and CPR are of great benefit for obstetricians to evaluate the status of fetus evidentially in singleton pregnancy.

OBJECTIVE: To compare the fetal pulmonary artery Doppler indices of pregnant women with autoimmune diseases such as systemic lupus erythematosus (SLE), Sjögren\'s syndrome (SS), and antiphospholipid syndrome (APS) with healthy pregnant women.
METHODS: Thirty-nine pregnancies were included in the case group, 19 of them SLE, 12 with SS, and eight with APS. The gestational age-matched 54 healthy pregnant women were included in the control group. Peak systolic velocity, time-averaged velocity, systolic/diastolic ratio, pulsatility index, resistance index, acceleration time (AT), ejection time (ET), and AT/ET ratio were obtained from pulmonary artery waveform by using spectral Doppler ultrasound.
RESULTS: Significantly shorter AT and lower AT/ET ratio were detected in the case group (p = < .001, p = < .001, respectively). The shortening of AT and decreasing of the AT/ET ratio were more predominant in the APS group. However, there was no significant difference between the SLE, SS, and APS groups in fetal pulmonary artery Doppler indices. Also, a moderate correlation was found between maternal disease duration (years) and fetal pulmonary artery AT (r = -.516, p = .001) and AT/ET ratio (r = -.558, p = < .001).
CONCLUSIONS: Fetal pulmonary artery Doppler indices may be affected in maternal autoimmune diseases. Further studies are needed to evaluate fetal pulmonary Doppler indices such as AT and AT/ET ratio to predict neonatal respiratory morbidity and lung maturation in pregnant women with SLE, SS, and APS.