SLIDE 1 THE USE OF SUPERB MICROVASCULAR IMAGING(SMI) TECHNIQUE FOR EVALUATING OVARIAN BLOOD FLOW AND COMPARISON OF SUPERB MICRO-VASCULAR IMAGING AND CONVENTIONAL DOPPLER IMAGING TECHNIQUES
Fatma Zeynep Arslan(1), Mehmet Sedat Durmaz(1), Serdar Arslan(1), Funda Gökgöz Durmaz(2) 1-University of Health Sciences, Konya Education and Research Hospital, Department of Radiology, Konya, Turkey 2-Turkish Ministery of Health, Public Health Institution Karatay 37th family health centre, Konya, Turkey
SLIDE 2
INTRODUCTION
Superb microvascular imaging (SMI) is a new vascularity imaging technique used to detect subtle low-flow components. Blood flow and tissue motion, called clutter, produce ultrasonic Doppler signals. SMI can differentiate flow signals from underlying clutter by using an adaptive algorithm. SMI has recently developed to overcome limitations of the conventional Doppler technique.
SLIDE 3
The cSMI mode simultaneously displays conventional grayscale ultrasound(US) with color-encoded Doppler signals. The mSMI mode improving sensitivity by subtracting away the background signals, and focuses only on the vasculature signals
SLIDE 4
AIM:
Comparing the sensivity of Superb Micro-Vascular
Imaging(SMI) technique in detecting intra-ovarian vasculary signal with that of conventional Doppler technique in healthy girls.
SLIDE 5 PATIENTS AND METHODS:
After the study was approved by the local ethics
committee, an informed oral and written consent was
- btained from all patients and healthy volunteers.
….test was used statistical analysis All patients prospectively examined on axial and
longitudinal planes using convex probe.
Totally 81 patients between 1 and 408 months (mean
age 178.9 months), and 162 ovaries were included in the study.
The examination began with an ovarian volume
measurement on the grayscale subsequently we evaluated BF in the ovaries via Color Doppler(CD), Power Doppler(PD), cSMI and mSMI techniques.
SLIDE 6
A seven-step grading system was established
based on the appearance on conventional Doppler and SMI technique…
SLIDE 7
grade0: 0 dot grade1: 1 dot, without linear microvasculary vessel being
demonstrated
grade 2: 2,3,4 dots, without linear microvasculary vessel
being demonstrated
grade 3: more than 4 dots without linear microvasculary
vessel being demonstrated
grade 4: less than or equal to 4 dots and linear
microvasculary vessel being demonstrated
grade 5: more than 4 dots and linear microvasculary
vessel being demonstrated
grade 6: more than one linear microvasculary vessel
being demonstrated with or without dots
SLIDE 8
The accuracy of each four modalities for detecting
intraovarian BF was interrogated on both plane using convex probe.
SLIDE 9 a.On gray scale imaging; left
- vary of 1-month-old female
healthy girl is seen, b.on color Doppler; no color doppler signal could be obtained in healthy
- varian tissue except for the
artefactic color doppler signal,
- c. on Power Doppler; doppler
signal can not be seen.
a b c
SLIDE 10 a b
a.On color SMI imaging; left ovary
- f 1-month-old female healthy girl
intra-ovarian signal which represent normal blood flow is absent, b.on monochrome SMI; 3 apparent dots, without lineer microvasculary vessel are demonstrated(Grade2).
b
SLIDE 11 a.On gray scale imaging; right
- vary of 14-year-old female
healthy girl is shown, (demonstrating volume of RO was 10 cc) , b.on color Doppler; no color doppler signal could be obtained in healthy ovarian tissue , c. on Power Doppler; doppler signal can not be seen.
a b c
SLIDE 12 a.On color SMI imaging; right ovary
healthy girl intra-ovarian signal which represent normal blood flow is absent(grade 2), b.on monochrome SMI; 3 apparent dots, without linear microvasculary vessel are demonstrated(grade 5).
a b
SLIDE 13 RESULTS:
SMI was found better for showing the vascular
flows.
The comparison of SMI with CD and PD revealed that
SMI was mostly superior to CD and PD in terms of detecting intraovarian BF.
We made a comparison between each of the four
- methods. The most superior method to determine
the intraovarian blood flow was mSMI. mSMI>cSMI>PD>CD
SLIDE 14
On Longitudinal plane examination using Convex
Probe ; while grade 5 was detected in 4 patients on CD, mSMI demonstrated 21 percent of all patients were grade 5. Table 1.
SLIDE 15 RESULTS:
As the ovaries volume decreases; a significant
increase is observed in mSMI when compared to
- ther examinations in showing vascularity.
SLIDE 16 CONCLUSION:
By detecting pediatric ovarian vascularity more
accurately in all ages with SMI, especially in pediatric populations and in younger children, SMI renders more detailed vascular information in screenning BF in the
- varies than either CD or PD imaging because SMI can
detect slow motion blood flows of microvascular structures.
As the ovaries volume decreases, the priority of SMI
showing especially BF increases significantly.
Thanks to these modalities, it is possible to provide
prompt decision and early laparoscopic exploration;thus, as much more ovarian tissue as possible could salvage from the necrosis-inducing effect of ovarian torsion.
SLIDE 17
Thank you…..
