scholarly journals Discrimination of fetal intracranial mass and hemorrhage via superb microvascular imaging in a case and review of literature

2021 ◽  
Vol 3 (1) ◽  
pp. 22-24
Author(s):  
Fatih Ateş ◽  
Halil İbrahim Sara ◽  
Mehmet Sedat Durmaz

In this case we aimed to present use of superb microvascular imaging (SMI) in the discrimination of fetal intracranial mass- haemorrhage with the light of literature. 21 weeks pregnancy woman applied to the clinic for routine obstetrics control. Ultrasonography (US) was applied to the patient. In the gray scale US, intracranial midline a large mass was detected. In the colour doppler (CD), the blood flow (BF) to the mass was not clearly seem. Power doppler (PD) was very artifact. In color SMI (cSMI) and monochrome SMI (mSMI), blood flow (BF) of the mass was seem clearly and fetal intracranial mass was prediagnosed. Magnetic Resonance imaging (MRI) was performed to determine the location of the mass, brain parenchyma and origin of the mass. Intracranial midline a large mass was detected in fetal MRI too. Although there are cases in the literature regarding the use of SMI in obstetrics, there is no case report in which fetal intracranial mass was evaluated by SMI to our knowledge. In our case; we have detected fetal intracranial mass by gray scale US, and we have evaluated vascularization of the mass by CD, PD, cSMI and mSMI. SMI modes were showing superiority when compared to CD and PD. Vascularization could be seen more clearly by mSMI when compared to cSMI.

2018 ◽  
Vol 29 (4) ◽  
pp. 2127-2136 ◽  
Author(s):  
Katharina Goeral ◽  
Azadeh Hojreh ◽  
Gregor Kasprian ◽  
Katrin Klebermass-Schrehof ◽  
Michael Weber ◽  
...  

2021 ◽  
Vol 14 (2) ◽  
pp. e239112
Author(s):  
Julian Alejandro Santos ◽  
Cherica Afurong Tee ◽  
Romelito Jose Galvan Galsim ◽  
Michael Lucas Tee

A 60-year-old woman with rheumatoid arthritis consulted for acute flare. She had elevated disease activity score 28 - erythrocyte sedimentation rate (DAS 28-ESR) of 6.88 and clinical disease activity index (CDAI) of 32. Her 12-joint ultrasound revealed widespread joint effusion. Synovial vascularity scores measured through superb microvascular imaging (SMI) and power Doppler were universally increased. We documented her treatment response 2 weeks after she received a single dose of biosimilar infliximab using clinical and sonographic data. Her DAS 28-ESR and CDAI scores decreased to 4.21 and 7.0, respectively. Reduction in synovial vascularity scores was demonstrated using SMI. While there was near total resolution in joint effusion and tenosynovitis, SMI was able to demonstrate synovial vascularity in joints with no clinical swelling nor tenderness. Musculoskeletal ultrasound and superb microvascular imaging are useful adjuncts in evaluating synovitis in rheumatoid arthritis and documenting treatment response through documentation of synovial vascularity, effusion and tenosynovitis.


2017 ◽  
Vol 7 ◽  
pp. 45 ◽  
Author(s):  
Suheil Artul ◽  
William Nseir ◽  
Zaher Armaly ◽  
Michalle Soudack

Determining the presence and characteristics of vascular flow is an essential part of sonography interrogation. However, small vessels and low velocities are not always possible to depict with conventional color and power Doppler ultrasound. This can be frustrating, especially when the diagnosis depends mainly on the existence of vascular flow, the sonographic examination will be inconclusive, further imaging examinations will be required and diagnosis delayed. Superb microvascular imaging (SMI) is a novel vascular imaging mode, which provides visualization of low velocity and microvascular flow. SMI uses a clutter suppression algorithm to extract flow signals and depicts this information as a color overlay image or as a monochrome or color map of flow. By using SMI, high frame rates and high-resolution images remain maintained. With SMI, it is possible to visualize small vessels including their branches that, until now, it is possible to demonstrate only using contrast-enhanced ultrasound. Availability of this additional technology on all ultrasound machines may make some of the computed tomography scans unnecessary. In our paper, we describe six patients, aged 16–73 years, in which final diagnosis was achieved only with SMI and where conventional color and power Doppler failed. All these examinations were performed using Aplio 500 Platinum ultrasound unit (Toshiba Medical Systems, Tokyo, Japan).


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