Search PubMed⌕ Search

Biomedical subjects

A Kurjak

Publications and source records attributed to A Kurjak.

At least 109 records · Page 6Linked to original sources
PubMed1992

The assessment of benign uterine tumor vascularization by transvaginal color Doppler.

Transvaginal color flow Doppler was used to study uterine flow and fibroid arterial supply. These studies were carried out in 101 patients with palpable uterine fibroids and 60 women attending the clinic for annual checkups. Blood flow impedance expressed as resistance index (RI), pulsatility index (PI), and blood velocity are calculated from the 5th to the 8th day of the menstrual calendar. Increased blood velocity and decreased RI and PI in both uterine arteries occurred in patients with uterine fibroids. The same technique was also used to study blood flow in the main arteries supplying identifiable fibroid. Diastolic flow in these arteries was always present and increased in comparison with uterine artery blood flow. The difference in uterine artery blood flow between patients with fibroids and healthy volunteers is statistically significant and may have predictable value in growth rate evaluation of the benign uterine mass.

Adult↗
PubMed1992

Renal arterial Resistance Index in pregnant and nonpregnant women: evaluation with color and pulse Doppler ultrasound.

The Resistance Index (RI) was studied in the main renal arteries in normal nonpregnant women and its change during normal pregnancy. One hundred and seventy color and pulse Doppler sonographic examinations were performed on 31 nonpregnant and 54 pregnant women. The range of gestation was 5-39 weeks, and patients divided into three groups; 5-12, 13-25 and 26-39 weeks of pregnancy, respectively. The RI was calculated in both main renal arteries. In nonpregnant women the left main renal artery RI mean = 0.587 +/- 0.021, and the right main renal artery RI mean = 0.584 +/- 0.028. In pregnant women the left main renal artery RI mean was 0.681 +/- 0.029, and the right main renal artery RI mean was 0.697 +/- 0.034. There was a significant difference between the main renal artery RI in pregnant and nonpregnant women (P less than 0.01). There was no significant difference between left and right main renal artery in pregnant and nonpregnant women (P less than 0.01). There was no correlation between gestational age and RI in the right main renal artery but a statistically significant correlation with gestational age in the left main renal artery (P less than 0.05).

Female↗
PubMed1992

Clinical value of the assessment of gynaecological tumour angiogenesis by transvaginal colour Doppler.

Angiogenesis occurs in the body in only a few physiological conditions, but it regularly precedes carcinogenesis. Neovascularisation is a term well known to the pathologist, but with the advent of colour Doppler it is now of interest to those using ultrasonography. Since morphological criteria alone are insufficient to characterise space occupying lesions, visualisation of newly formed vessels and consequently, their blood flow characteristics, seems to provide a clearer distinction in vivo between benign and malignant gynaecological tumours. Very low resistance indices in newly formed vessels, as a predictor of malignancy, have already been established. The most recent area of investigation covering the differences between centrally and peripherally placed vessels offers additional criteria for diagnosing gynecological malignancy.

Female↗
PubMed1992

New scoring system for prediction of ovarian malignancy based on transvaginal color Doppler sonography.

The goal of this prospective study was to develop a new scoring system using transvaginal color and pulsed Doppler characterization of ovarian lesions. Transvaginal color Doppler sonography was performed on 812 women, among whom 174 adnexal masses were found and analyzed. Ovarian lesions were assessed by means of morphological and color Doppler scoring systems. Tumors were characterized ultrasonically as benign or suspected of being malignant. Scoring system results were correlated with histopathological findings. Among our study group, 38 malignant and 136 benign ovarian tumors were found and verified. The color Doppler scoring system was very useful in distinguishing benign from malignant masses, with a sensitivity of 97.3% and a specificity of 100%, compared with the morphological scoring system's sensitivity of 92.1% and specificity of 94.8%. We also evaluated a combination of both scoring systems. We believe that new color Doppler scoring system maximizes the ability to discriminate between benign and malignant entities.

Adult↗
PubMed1992

Congenital malformations of the respiratory tract.

Malformations of the respiratory tract were found in 21 out of 205 foetuses (10%) in whom various congenital malformations had been prenatally detected by ultrasonography and amniocentesis. Pulmonary hypoplasia was the most common of all pulmonary malformations and was established in 17 cases (81%). Lung alobulation was established in two cases (9.5%), and pulmonary cysts were recorded in another two cases in post-mortem examinations. Correlations established between ultrasonographic and pathomorphological findings were not satisfactory as only 29% of all ultrasonographic diagnosis were complete and correct. Hence, much closer cooperation between the pathologist and clinician is essential to all investigations of congenital malformations, in particular to those of complex nature.

Abortion, Induced↗
PubMed1992

Transvaginal ultrasound, color flow, and Doppler waveform of the postmenopausal adnexal mass.

One thousand postmenopausal women were examined prospectively with transvaginal ultrasound. Seven hundred forty-three (74%) were asymptomatic and presented for screening. Data were analyzed to determine the accuracy of this new modality. Eighty-three women had surgery, and 29 malignant neoplasms were found. Color flow was identified in 27 of 29 malignant tumors and 35% of benign masses. A cutoff value of 0.41 for the Doppler resistance index in the feeder vessels had the best discriminatory value; sensitivity and specificity were 96 and 95%, respectively, for separating benign from malignant neoplasms. Positive and negative predictive values were 96 and 95%, respectively. Morphology alone had poor sensitivity, but when combined with Doppler indices, the sensitivity improved to 90% and the positive and negative predictive values were 90 and 96%, respectively. The results of this study suggest that in the postmenopausal ovary, transvaginal B-mode imaging, color flow, and Doppler indices satisfy criteria as tests that may be sensitive and specific enough for application in a screening program.

Adult↗
PubMed1991

The characterization of uterine tumors by transvaginal color Doppler.

The present study aimed to evaluate the possibility of using transvaginal color Doppler and spectral analysis to differentiate between malignant and benign uterine tumors. This method was performed on 308 patients with uterine tumors before gynecological surgery. The final diagnosis was made following pathological examination of the uterus. There were 291 benign and 17 malignant uterine tumors. Tumor arterial blood flow was detected in 134 (58%) patients with myoma (RI = 0.58 +/- 0.12 SD), 23 (42.6%) patients with adenomyosis (RI = 0.67 +/- 0.14), 12 (92.3%) patients with endometrial carcinoma (RI = 0.34 +/- 0.05)) three (100%) patients with uterine sarcoma (RI = 0.31 +/- 0.03) and in one case (100%) of sarcoma botryoides (RI = 0.33). Blood flow was not detected in patients with endometriotic cysts (n = 6). The comparison of RI between patients with uterine myoma and endometrial cancer showed a significantly lower RI in the cases of endometrial carcinoma (t = 13.5; p < 0.01). Our results showed that transvaginal color Doppler has potential in the non-invasive differentiation of benign and malignant uterine tumors.

Journal Article↗
PubMed1991

Investigation of placental circulations by color Doppler ultrasonography.

The placental circulations of 25 normal and five complicated pregnancies were studied by color Doppler ultrasonography. Flow velocity waveforms were obtained in all 30 pregnancies and could discriminate between fetal and maternal intraplacental blood flow. We believe that color Doppler ultrasonography will improve our understanding of the pathophysiology of various pregnancy disorders that alter the placental circulations and that color ultrasonography is useful for the prenatal differential diagnosis of intrauterine masses.

Blood Flow Velocity↗
PubMed1991

Transvaginal color flow Doppler in the assessment of ovarian and uterine blood flow in infertile women.

OBJECTIVE: To measure the flow velocity of the uterine and ovarian arteries through the menstrual cycle to determine there are changes. DESIGN: Serial measurements throughout the menstrual cycle in women attending an infertility clinic, compared with volunteers coming for annual examinations. Transvaginal ultrasound-color flow Doppler was the investigative tool. SETTING: A University Hospital ambulatory care center. PATIENTS: One hundred infertile women compared with 150 women attending the clinic for annual checkups. MAIN OUTCOME MEASURES: Changes in the resistance index of flow velocity waveforms of the uterine and ovarian arteries. RESULTS: Uterine flow velocity has a resistance index of 0.88 +/- 0.04 (2 SE) in the proliferative phase and starts to decrease the day before ovulation. A nadir of 0.84 +/- 0.04 is reached on day 18 and remains at that level for the rest of the cycle. In anovulatory cycles, these changes do not occur. A subgroup of 12 women who lacked end diastolic flow in the uterine arteries during the secretory phase were identified. Eleven of these women were infertile, 8 of whom with primary infertility. Ovarian artery flow velocity is usually detected when the dominant follicle reaches 12 to 15 mm. The resistance index is 0.54 +/- 0.04 and also declines on the day before ovulation. A nadir of 0.44 +/- 0.04 is reached 4 to 5 days later and slowly rises to 0.050 +/- 0.04 before menstruation. CONCLUSIONS: There are changes in the flow velocity patterns of the uterine and ovarian arteries during the normal ovulatory menstrual cycle. Because these changes in flow velocity begin before ovulation, it can be suspected that they may involve angiogenesis as well as hormonal factors. The changes noted in these studies are statistically significant but may be too small to be used as a diagnostic tool in the study of infertility problems.

Adult↗
PubMed1991

Ovarian morphology, endocrine function and intra-follicular blood flow during the peri-ovulatory period.

Transvaginal ultrasonography with colour flow mapping has been used to study changes in intra-follicular morphology and blood flow during a peri-ovulatory period in one volunteer. Aspects of uterine morphology and blood flow were also recorded. The intervals from a defined luteinizing hormone (LH) rise and peak to the mean time of follicular rupture were 37.5 and 17.5 h, respectively. Blood flow velocity waveforms were observed clearly at the time of the LH rise and blood vessels were visible when the hormone level reached a peak. Concurrently, the wall of the follicle became less clear, crenated, thicker and more echogenic. A structure resembling the detached cumulus and oocyte was seen before the follicle had ruptured. Peak systolic blood velocity was highest immediately after ovulation had occurred. Blood flow impedance in the uterine arteries suggested the presence of a circadian rhythm, but no pronounced daily changes were observed over the study period. In contrast, flow velocity waveforms were clearly visible in the endometrium around the time of ovulation. These preliminary data suggest that intra-follicular vascularization or angiogenesis may be critical processes that might be used to predict ovulation and could possibly be modified to help achieve or avoid a pregnancy.

Adult↗
PubMed1991

Transvaginal color Doppler in the assessment of abnormal early pregnancy.

The study groups comprised 61 pregnant women whose gestational age ranged from 7 to 12 weeks from the last menstrual period. All patients apparently had a normal developing pregnancy; there were no clinical symptoms of pathology e.g. bleeding in early pregnancy. Eighty-two patients with a clinically and ultrasonographically normal pregnancy whose gestational age ranged from 7 to 12 weeks, served as a control group. When the anatomical position of investigated area have been obtained clearly, pulsed wave Doppler sample volume was placed on the structures of interest: the both uterine arteries and intervillous space. There is no statistically significant difference between the Resistance Index (RI) in the left or right uterine artery (P greater than 0.01) and among investigated groups of patients (P greater than 0.01). The intervillous blood flow RI in the case of molar pregnancy was 0.38 with SD +/- 0.03; in blighted ovum 0.43 with SD +/- 0.03, and in missed abortion 0.43 with SD +/- 0.02. It should be stressed that in nine (31%) cases of blighted ova and in five (26%) cases of missed abortion, intervillous space flow could not be detected. In the control group, intervillous blood flow was always visualized and the mean RI was 0.45 with SD - 0.04. Statistical analysis showed significantly higher RI in control group in comparison with other groups of patients (P less than 0.01), and significantly lower RI in molar pregnancy in comparison with other groups of patients (P less than 0.01). There was no difference in RI between blighted ova and missed abortions (P greater than 0.01).

Abortion, Missed↗
PubMed1991

Ectopic pregnancy: transvaginal color Doppler of trophoblastic flow in questionable adnexa.

The purpose of this study was to see if color flow Doppler measurements could aid in the positive diagnosis of ectopic pregnancy when no gestational sac can be seen in the adnexa. We examined 148 women with abdominal pain and suspected ectopic pregnancy by abdominal ultrasonography, followed by vaginal ultrasonography and color Doppler when the diagnosis was still uncertain. Seventy-three patients proved to have ectopic pregnancies. Color flow with low resistance and high velocity vascular signals were observed in complex adnexal masses and in some of the corpora lutea. The resistance index for ectopic trophoblast was 0.36 +/- 0.02 SD. Color Doppler had both positive and negative discrimination of adnexal masses (P = 10(-15). The resistance index for the corpora lutea was 0.48 +/- 0.04. A cutoff value of 0.40 or less is proposed as a diagnostic index for suspected trophoblast in the adnexa. In nine cases of ectopic pregnancy, no color flow was noted. In these women, the beta-human chorionic gonadotropin level was less than 1000 mIU/ml. The clinical operative suspicion in these cases was tubal abortion. Sensitivity and specificity were 88% and 97%, respectively, in this highly selective series. Positive and negative predictive values were 97% and 89%. Color Doppler appears to be useful for the positive diagnosis of ectopic pregnancy with ultrasonography when no adnexal gestational sac is observed. Prospective randomized trials will determine the ultimate clinical value of these findings.

Adnexa Uteri↗
PubMed1991

Evaluation of adnexal masses with transvaginal color ultrasound.

We evaluated 14,317 asymptomatic or minimally symptomatic women for ovarian carcinoma with transvaginal color Doppler ultrasound. The resistance index was calculated for at least five separate cardiac cycles in each case, and the mean was calculated. We discovered 624 benign adnexal masses: in every case except one the resistance index was greater than 0.40. There were 56 malignant adnexal masses, 16 of which were stage I ovarian cancers. Neovascularization was found in six of the seven stage I primary neoplasms and in all of the nine stage I secondary ovarian cancers. In all, the RI was less than or equal to 0.40. There were 40 advanced ovarian cancers revealed (stage III or IV); 39 showed abnormal color-flow pattern with the resistance index less than 0.04.

Adult↗
PubMed1991

[Interventional ultrasound in the diagnosis and therapy of fetal malformations].

The author discusses his own experience in ultrasonically guided needle diagnosis and treatment of foetal malformations. Over the period from January 1, 1980 to May 1, 1985 1266 amniocenthesis, 50 chorion biopsies, 32 heart punctures, 15 craniocenthesis, 10 decompressions of obstructed urinary tract, 1 urinary shunt catheter placement, 2 ovarian cyst punctures, 1 thoracocenthesis and 110 intraamniotic instillations of prostaglandins and hypertonic saline solution, were performed. The author concludes that ultrasound is of major importance in antenatal diagnosis and treatment of foetal malformations, but that the clinical potential of these procedures should not be under-or over-estimated.

Adult↗