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ECR 2018 / C-1428
Novel microvascularization hemodynamic detection ultrasound technology applied in multiple clinical applications
Congress: ECR 2018
Poster No.: C-1428
Type: Scientific Exhibit
Keywords: Abdomen, Extremities, Thyroid / Parathyroids, Ultrasound, Ultrasound-Colour Doppler, Ultrasound-Power Doppler, Diagnostic procedure, Blood
Authors: G. Malferrari1, E. Papini2, A. batticciotto3, G. zhang4, A. Dell'Era5, L. Forzoni6, Y. Wang4, L. Zhou7, G. Bizzarri2; 1Reggio Emilia/IT, 2Albano Laziale/IT, 3Milano/IT, 4Harbin/CN, 5Genova/IT, 6Firenze/IT, 7Shanghai/CN


The results of the evaluation of microV technology done by different users in different clinical applications, are here below reported:


1. Neurosonology: cerebral media artery stenosis

A comparison was applied between color technique and power, both with low and high scale (Pulse Repetition Frequency – PRF), and microV. It was achieved not only a higher resolution in the morphological definition of the vessel, but also the different flow velocity, which allowed us to study intracranial stenosis not detected by the conventional Doppler methods currently in use in everyday clinical practice.

The microV technique allowed us to obtain a high depth of insonation up to 12 cm in depth, in combination with very high spatial resolution (which was not achieved with standard Doppler techniques).

microV allowed us to understand that the high velocities, we initially attributed to a hypothetical stenosis of the cerebral media at the origin, were actually due to the tortuosity of the vessel.

This technique allowed us to combine high spatial resolution with high sensitivity. Moreover, this technique was very easy to use. See Figures 4 and 5.


2. Endocrinology: thyroid nodules

Color enhancement of the ultrasound images, that delineates the vasculature, is essential. Comprehensive understanding of the local anatomy and the specific disease process was possible only with microV in case of low and weak flows.

microV provided elevated sensitivity for slow flow detection in thyroid lesions with a clear depiction of the small vessel architecture. This new technology was rapid, not invasive, and inexpensive. These characteristics allowed its use as a further diagnostic tool in routine sonographic examination of thyroid nodules with suspicious ultrasound features or with indeterminate cytology at fine needle aspiration biopsy. See Figures 6 and 7.


3. Endocrinology: cervical lymph nodes

A comparison of blood flow visualization inside the cervical lymph node was performed with three different techniques: Color Doppler, directional Power Doppler and microV. The microV image demonstrated more well-characterized blood flow inside the lymph node than the Color Doppler image and directional Power Doppler. In addition, microV ensured the best low-velocity flow visualization, compensating for motion artefacts and without any relevant interference from hyper-echoic structures or background noise. See Figure 8.


4. Liver: hepatic hemangioma

The hepatic hemangiomas exhibit a specific pattern when compared to other liver tumors.

A comparison between Color Doppler flow map and microV was performed, which showed fine and very low velocity blood flow inside the hepatic hemangioma (not detectable even on directional Power Doppler modality). Higher sensitivity without background noise and a high frame rate has the aim to allow the characterization of the features and pattern details among different types of hepatic tumors. See Figure 9.


5. Kidney: renal cortex

Color and Power Doppler were limited in their ability to evaluate perfusion of the renal cortex.

Furthermore, the distal micro-vasculature of the renal parenchyma could be clearly demonstrated with microV Advanced Hemodynamic Evaluation technology.

The best results were achieved with microV, thanks to the several different palette patterns available. See Figures 10 and 11.


6. Musculoskeletal/Rheuma: synovitis

Erosive active synovitis in a patient affected by rheumatoid arthritis was analyzed with both microV and power Doppler technologies. Side-by-side comparison of the second metacarpophalangeal joint confirmed that microV revealed more blood flow at the level of the inflamed synovial pannus. See Figure 12.


7. Musculoskeletal/Rheuma: nail bed

microV technology was used for analyzing the normal nail bed revealing more blood flow than standard Power Doppler techniques. The sensitivity and resolution of microV were much higher than Color Doppler. microV had the capability to display the micro-vascularization between the upper and lower nail bed, which is very useful for evaluating early rheumatoid arthritis. See Figure 13.


8. Musculoskeletal/Rheuma: metatarsophalangeal joint evaluation in rheumatoid arthritis

microV technology used for analyzing the fourth metatarsal-phalangeal joint of an active rheumatoid arthritis patient revealed more blood flow than Power Doppler techniques at the level of the thickened synovial membrane, also thanks to the fact that microV is bi-directional and has high sensitivity spatial resolution. See Figure 14.

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