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Abstract Aim The present study was performed to characterize and compare the perfusion of vaginal and uterine arteries after challenging the reproductive tract of dairy cows via natural mating, artificial insemination (AI), or intravaginal deposition (vaginal fundus) of different biological fluids or a placebo. Materials and methods In a double-blind study, six German Holstein cows were administered PGF2α during dioestrus and 48 h later treated with GnRH. Intravaginal or intrauterine treatments were carried out 12 h after GnRH was administered. Animals served as their controls, using a cross-over design with an interval of 14 days between experiments. The experimental animals were allocated to receive the following treatments: natural mating (N), intrauterine artificial insemination (A), intravaginal deposition (vaginal fundus) of 6 mL raw semen (R) or 6 mL seminal plasma (S), and compared to their controls [control 1: 6 mL placebo (P: physiological saline); control 2: no treatment (C)). Corresponding time intervals were chosen for the untreated control oestrus. Blood flow volume (BFV) in the uterine (u) and vaginal (v) arteries ipsilateral to the ovary bearing the preovulatory follicle was determined using transrectal Doppler sonography. Results All animals exhibited oestrus and ovulated between 30 and 36 h after GnRH. Transient increases (P 0.05). Only mating and deposition of either raw semen, seminal plasma or AI increased uBFV (P

Aim: The present study was performed to characterize and compare the perfusion of vaginal and uterine arteries after challenging the reproductive tract of dairy cows via natural mating, artificial insemination (AI), or intravaginal deposition (vaginal fundus) of different biological fluids or a placebo. Materials and methods: In a double-blind study, six German Holstein cows were administered PGF2α during dioestrus and 48 h later treated with GnRH. Intravaginal or intrauterine treatments were carried out 12 h after GnRH was administered. Animals served as their controls, using a cross-over design with an interval of 14 days between experiments. The experimental animals were allocated to receive the following treatments: natural mating (N), intrauterine artificial insemination (A), intravaginal deposition (vaginal fundus) of 6 mL raw semen (R) or 6 mL seminal plasma (S), and compared to their controls [control 1: 6 mL placebo (P: physiological saline); control 2: no treatment (C)). Corresponding time intervals were chosen for the untreated control oestrus. Blood flow volume (BFV) in the uterine (u) and vaginal (v) arteries ipsilateral to the ovary bearing the preovulatory follicle was determined using transrectal Doppler sonography. Results: All animals exhibited oestrus and ovulated between 30 and 36 h after GnRH. Transient increases (P < 0.05) in vaginal blood flow occurred between 3 and 12 h following mating as well as 3 to 9 h after deposition of raw semen and seminal plasma, respectively. The most distinct increases (199%) in vBFV occurred 6 h after mating compared to values immediately before mating (= time 0 h). Neither AI nor deposition of a placebo into the vagina affected vBFV (P > 0.05). Only mating and deposition of either raw semen, seminal plasma or AI increased uBFV (P < 0.003). The greatest rise in uBFV occurred after natural mating. Maximum uBFV values were detected 9 h after mating when values were 79% greater (P < 0.05) than at 0 h. Conclusions: The natural mating, deposition of raw semen or seminal plasma and conventional AI affect vaginal and/or uterine blood flow to different degrees. The factors responsible for these alterations in blood flow and their effects on fertility remain to be clarified in future studies. [ABSTRACT FROM AUTHOR]

Simple Summary: This study examined the appearance and changes of canine testes from birth to adulthood by using ultrasound. Eight Beagle dogs were monitored from 4 to 40 weeks of life. The following parameters were evaluated every 14 days: bodyweight and height, scrotal sac and testicular volume, ultrasonographically measured testicular volume, echogenicity, heterogeneity, blood-flow score, ratio of the grayscale intensity value of the testis to the capsule, and semen quality. A correlation analysis was carried out between the various measurements obtained. Fertility was achieved in the 36th week. The echogenicity of the testicular parenchyma progressively increased with age. The ratio of grayscale intensity of testicular parenchyma had values < 200 at maturity. A colour Doppler evaluation first detected blood flow in the testis in the 22nd week, and in the 36th week > 80% of the testes imaged had visible vessels. A significant correlation was found between all the evaluation methods. The findings of the study may help clinicians to detect maturity in dogs; however, their applicability in all breeds or individuals might possibly vary due to genetic, physiological, and developmental differences. In summary, the study ultrasonographically explores the testicular maturity in dogs, with the aim to improve clinical assessments and health management in these animals. This prospective study investigated the ultrasonographic appearance of the canine testis from birth to adulthood. Eight purpose-bred laboratory Beagle-breed dogs were monitored from 4 to 40 weeks of life. The following parameters were evaluated every two weeks: bodyweight and height, scrotal and testicular volume, ultrasonographically measured testicular volume, echogenicity, heterogeneity, blood-flow score, ratio of the grayscale intensity value of the testis to the capsule, ejaculate volume, motility, viability, and number of spermatozoa. A correlation analysis was carried out between the various measurements obtained. Fertility was achieved in the 36th week of life. The echogenicity of the testicular parenchyma increased with age, and subsequently to the 30th week of life remained constant. The heterogeneity of the testicular parenchyma, as was evaluated by the standard deviation of the values of grayscale intensity of the parenchyma, also increased with age and was >19 at the onset of fertility. The ratio of grayscale intensity of testicular parenchyma had values < 200 at maturity. A colour Doppler evaluation first detected blood flow in the testis in the 22nd week. After the 32nd week, distinct signals were visible. In the 36th week, >80% of the testes imaged had visible vessels. A significant correlation was found between all the evaluation methods. The findings of the study may help clinicians detect the onset of fertility in dogs, especially when semen evaluation is not feasible; however, their applicability in all breeds or individuals might possibly vary due to genetic, physiological, and developmental differences. In summary, the study ultrasonographically explores the testicular maturity in dogs, with the aim to improve clinical assessments and health management in these animals. [ABSTRACT FROM AUTHOR]

Mateusz Zarzecki,1 Iwona Obuchowska,1 Andrzej Ustymowicz,2 Joanna Konopi&nacute;ska1 1Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland; 2Department of Radiology, Medical University of Bialystok, Bialystok, PolandCorrespondence: Joanna Konopi&nacute;ska, Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland, Tel +48-857468372 ; +48-600471666, Fax +48-857468604, Email joannakonopinska@o2.plAbstract: Glaucoma is a common cause of blindness worldwide. This disease is characterised by increased intraocular pressure (IOP) and the concomitant disruption of ocular haemodynamic. Several studies have demonstrated that trabeculectomy is associated with changes in extraocular blood flow. In this study, we reviewed the available evidence on the use of colour Doppler imaging to evaluate and manage patients with open-angle glaucoma. We present the detailed anatomy of ocular blood flow to provide a background for the research findings. We also discuss the physiological foundations of ocular blood flow and detailed flow characteristics of specific extraocular vessels. Finally, we reviewed published studies that analysed the effects of glaucoma surgery on the blood flow parameters of the eye.Keywords: glaucoma, colour doppler, trabeculectomy, deep sclerectomy

Introduction: The axillary lymph nodes are the most prevalent location of breast cancer metastases. One of the most important and dependable prognostic variables for individuals with breast cancer is the presence of axillary lymph nodes. It's critical to distinguish benign axillary lymph nodes from malignant ones as soon as possible in order to enhance survival and outcomes and avoid treatable lesions from becoming incurable. Aims: In this study, axillary lymph nodes in women with breast cancer were evaluated by strain wave elastography, colour doppler, and greyscale ultrasonography, and their histologic correlation was examined. The current study also examined the specificity, sensitivity, negative and positive predictive values, and combination of elastography and greyscale ultrasound results with greyscale ultrasound results. Methods: Following a histopathology-based diagnosis of carcinoma in the breast, 68 individuals had their axillary lymph nodes evaluated for vascularity, shape, size, hilum presence or absence, cortical thickness, fatty hilum thickness ratio (C/F ratio), long/short axis ratio (L/S ratio), and elastography. Results: The diagnosis was established, and histology supported it. Increased C/F ratio, decreased L/S ratio, increased cortical thickness, eccentric/compressed or missing hilum, irregular nodular borders, and round shape in morphology were observed to be favourable factors for malignancy. Based on the resistivity index, vascular flow pattern type, and peak systolic/end-diastolic velocity/ratio, benign and malignant lymph nodes were distinguished. The mean strain ratio was greater in malignant lymph nodes than in benign lymph nodes. Conclusions: Because ultrasound is accurate, easily accessible, radiation-free, and reasonably priced, it should be routinely included in the initial screening of subjects with breast carcinoma. This includes strain elastography, colour Doppler, and greyscale ultrasound. [ABSTRACT FROM AUTHOR]

Vein of Galen aneurysmal malformation (VGAM) is a rare vascular anomaly originating during embryonic development, specifically between the 6th and 11th weeks of gestation. This malformation results from abnormal arteriovenous connections between primitive choroidal arteries and the median prosencephalic vein (MPV) of Markowski. Typically, the MPV regresses by the 11th week, but in VGAM, this regression is hindered, leading to persistent abnormal flow and the formation of arteriovenous shunts. We present a case of successful prenatal detection, as well as a comprehensive literature review that summarizes current knowledge, emphasizes the importance of prenatal detection, detailed imaging techniques, understanding clinical presentations, and outlines treatment options. Prenatal detection, crucial for early intervention, has become feasible through ultrasonography and MRI. Fetal MRI has emerged as the gold standard, offering detailed insights into arterial feeders, nidus presence, fistula position, venous drainage, and potential complications. The clinical presentation of VGAM varies with age, and neonates diagnosed in utero may exhibit signs of high-output cardiac failure. Early detection is critical for timely intervention, as untreated VGAMs often result in high mortality rates. Prognosis depends on the severity of heart failure, the number of arteriovenous shunts, and the presence of accompanying fetal abnormalities. Various imaging modalities, including CT angiography and digital subtraction angiography (DSA), aid in the assessment and treatment of VGAM. DSA remains the gold standard for evaluating angioarchitecture and guiding endovascular interventions. The optimal treatment for VGAM is transarterial embolization, offering significant improvements in prognosis. Surgical interventions are limited due to high morbidity and mortality. Management decisions should consider the balance between minimizing neurological damage and achieving maximum embolization effectiveness.

Purpose: To evaluate the segmental variations in portal venous pulsed wave colour Doppler flow velocity in patients with moderate to severe non-alcoholic fatty liver disease in comparison with healthy controls Materials and Methods: In this prospective, observational, case–control study, the maximum velocity of all the segmental branches of portal vein were evaluated on colour Doppler in patients with moderate to severe non-alcoholic fatty liver disease, and the values were compared between three groups (1) Healthy controls (n = 30), (2) non-alcoholic fatty liver disease group, that is moderate to severe fatty liver without features of portal hypertension (n = 32) and (3) non-alcoholic steatohepatitis-portal hypertension group, that is those non-alcoholic fatty liver disease patients with features of portal hypertension (n = 13). Results: Compared to controls, non-alcoholic fatty liver disease group showed a lower velocity in all the eight segments of liver. The ratio of segment 2 to segment 7 peak portal vein maximum velocity was significantly higher in non-alcoholic fatty liver disease (1.03 ± 0.21) compared to controls (0.90 ± 0.17) and even higher in non-alcoholic steatohepatitis-Portal hypertension group (1.83 ± 0.40) with p value of 0.003. Conclusion: Our study demonstrates the occurrence of flow redistribution occurring in cases of non-alcoholic fatty liver disease patients with the left lobe receiving higher portal venous flow. This flow redistribution was even more pronounced in a subset of non-alcoholic fatty liver disease patients who developed features of portal hypertension. [ABSTRACT FROM AUTHOR]

During antenatal period, the fetus and mother are connected through placenta, a structure that perform the functions of supplying nutrients to foetus, exchange of gases and elimination of waste through well maintained blood circulation. Thus, foetal health is dependent on this circulation. Any impairment in it can cause adverse effects on foetus. The present case study aimed at understanding the effect of yoga and Indian classical music on maternal and foetal health. Along with routine antenatal care, the patient was advised yoga exercises and listening to some Indian classical music ragas. Today, the effect of yoga and music has been examined on various physical and psychological dimensions of pregnant women. However, there are still sparse studies on the effect of yoga and music on the uterine artery indices as well as maternal and foetal complications. It was found that yoga and classical music resulted in improved uterine artery indices, foeto-maternal health and good foetal outcome. [ABSTRACT FROM AUTHOR]

Enhanced myometrial vascularity is a rare entity in which an abnormal communication between vessels of the myometrial wall, potentially derived from all pregnancies, increases bleeding risk. Spontaneous regression is possible, but often, it is not foreseeable in which cases it's better to adopt a waiting behaviour and in which others a treatment is required. We reported three cases of enhanced myometrial vascularity: two occurring after vaginal delivery, and the third one after a scar pregnancy. The first case was successfully treated by embolization, the second one was subjected to curettage complicated by uterine perforation; the third one underwent embolization as well, but subsequently required hysterctomy for persistent methrorragia. As we treated these similar cases in three different ways, we decided to perform a mini review of the literature in the aftermath. Considering literature data, we strongly believe that the detection of peak systolic speed by colour-Doppler ultrasound together with a careful evaluation of clinical symptoms, could be a good guide to the best treatment of each patient. [ABSTRACT FROM AUTHOR]

Purpose: To demonstrate shunt flow through small ventricular septal defects (VSDs) using HDlive Flow with spatiotemporal image correlation (STIC) and HDlive Silhouette. Methods: Four cases of isolated small VSDs were evaluated using colour Doppler, and HDlive Flow with STIC and HDlive Silhouette. Results: HDlive Flow with STIC and HDlive Silhouette can improve the ability to depict shunt flow through small VSDs compared with colour Doppler. Conclusion: This technique provides information on spatial recognition of the shunt flow through isolated small VSDs in real time. [ABSTRACT FROM AUTHOR]

This article discusses the role of color Doppler ultrasound and magnetic resonance angiography (MRA) in the evaluation of extracranial carotid and vertebral arteries in patients with stroke. The study involved 120 patients who were examined using both Doppler ultrasound and MRA. The findings of both modalities were compared, and the percentage of stenosis was given based on the North American Symptomatic Carotid Endarterectomy Trial (NASCET) classification. The study found that the age group most affected by stroke was 51-60 years, and the gender distribution was skewed towards males. The majority of patients had soft tissue plaque, and right-side involvement was most common. The study concludes that the combination of Doppler ultrasound and MRA provides complementary information and can be helpful in characterizing atherosclerotic plaque and detecting carotid stenosis. [ABSTRACT FROM AUTHOR]

The aims of the present study were to determine uterine, vaginal and placental blood flows by Doppler ultrasound cross-buffalo gestation and to evaluate the relationships among reproductive Doppler parameters and serum metabolic parameters as well as oxidative stress. Uterine (UA) and vaginal (VA) arteries were scanned every month, and placentome was scanned from month 4 till 8 in gestation. Time-averaged maximum velocity (TAMV), pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (SD) and arterial diameter (AD) were used for accessing UA and VA hemodynamics. Time-averaged maximum velocity positively correlated with and AD, and both negatively correlated with their PI, RI and SD in UA and VA. TAMV and AD increased constantly in pregnancy, with maximum increase in months 4 and 9. Pulsatility index, RI and AD of UA decreased between months 4 and 9, while PI, RI and AD of VA decreased between months 5 and 9 and then increased in month 10 in pregnancy. Time-averaged maximum velocity of placentome blood flow increased exponentially from months 4 to 8, but decreased at the last two months in pregnancy. Serum lipids were significantly higher in the first month compared to all other months, while glucose was significantly lower in months 9 and 10. Malondialdehyde increased from month 3 till term, but peaked in month 5 and 10. Glutathione and catalase were highest in the first month and remained after. Time-averaged maximum velocity and AD for both UA and VA negatively correlated with serum lipids, glucose, catalase and glutathione, while positively correlated with malondialdehyde and total protein. Thus, increases in uterine blood flow (UtBF), vaginal blood flow (VaBF) and placental blood flow (PaBF) are associated with increased metabolism and oxidative stress in buffalo pregnancy.

Objective: To evaluate the efficacy of high-resolution ultrasound and colour Doppler in differentiating neoplastic and nonneoplastic causes of cervical lymphadenopathy compared to histopathological diagnosis. Study Design: Cross-Sectional study. Place and Duration of Study: Pakistan Institute of Medical Sciences, Islamabad Pakistan, from Jan to Jun 2019. Methodology: The study included 110 patients with palpable cervical lymph nodes undergoing neck ultrasound and Fine needle aspiration cytology/Biopsy. Certain important sonological features were considered to categorize them into nonneoplastic and neoplastic groups. Colour Doppler imaging was employed along with grey-scale imaging. The histopathology results were compared with sonographic findings to determine the diagnostic accuracy of ultrasound in differentiating neoplastic from non-neoplastic causes of enlarged cervical lymph nodes. Results: Our study revealed that High-resolution sonography has 94.4% sensitivity and 88.8% specificity, differentiating between neoplastic and non-neoplastic causes of cervical lymphadenopathy. At the same time, the overall accuracy of ultrasound is 90.9%. The most consistent grey-scale feature in the non-neoplastic nodal group was preserved central fatty hilum, while its loss was significantly associated with neoplastic etiologies. Conclusion: Due to high sensitivity and negative predictive value, high-resolution sonography can be deployed as a first-line investigating tool for enlarged lymph nodes, and invasive procedures like Fine needle aspiration cytology (FNAC) can be abandoned in non-neoplastic lymphadenopathies.

The study focused on the application value of the space compounding algorithm‐based colour Doppler ultrasound twinkling artefacts in predicting chemical components of urinary tract stones. Specifically, the minimum variance method was used to optimize the space‐compounding algorithm to improve the quality of colour Doppler ultrasound artefacts. Then, the urinary system stone model was built to quantitatively analyse the influence of stone components on colour Doppler twinkling artefacts. The results showed that no notable differences were noted in the twinkling artefact intensity (TAI), the width of twinkling artefact (TAW), and the length of twinkling artefact (TAL) between the oxalic acid monohydrate, hydroxyapatite, uric acid, and cystine stone models (p < 0.01). The area under the curve (AUC) of the TAI for the diagnosis of calcium‐free calculus models was 0.978, that of TAW was 0.9462, and that of TAL was 0.9315. The diagnostic sensitivity and specificity of TAI were 89% and 96%, respectively, the diagnostic sensitivity and specificity of TAW were 86% and 80%, respectively, and the diagnostic sensitivity and specificity of TAL were 78% and 97%, respectively. The ability of TAL (AUC of 0.953) to distinguish between hydroxyapatite stone model and cystine stone was better than TAI (AUC of 0.702) and TAW (AUC of 0.657) (p < 0.01); and TAL and TAW were positively correlated with TAI (R2 was 0.79 and 0.68, respectively, p < 0.01). In conclusion, the space compounding algorithm based on minimum variance method can improve the quality of colour Doppler ultrasound twinkling artefacts, and colour Doppler ultrasound twinkling artefacts can predict the chemical components of urinary stones, which can be used as a criterion for clinical diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Continuous stimulation of thyroid gland occurs during pregnancy in order to meet the demands of growing foetus. This might result in variations in thyroid gland morphology which may be misdiagnosed if not assessed accurately. Ultrasonography can measure these variations during pregnancy in the form of change in volume, echotexture, nodularity etc. Aim: To compare the thyroid volume and nodules using ultrasound, amongst different trimesters of pregnancy and with non pregnant women of similar age and find the correlation with different factors. Materials and Methods: A time-bound, hospital-based, crosssectional observational study was done in the Department of Radiodiagnosis, Maharaja Yeshwantrao (MY) Hospital, Indore, Madhya Pradesh, India, from April 2021 to August 2022 on 240 patients. All subjects were divided into groups of 60 women each, which included non pregnant women in group 1 and pregnant women during each trimester in rest three groups, as group 2, 3 and 4, respectively. Thyroid volume and nodules were measured in each group. The descriptive data was calculated using mean and standard deviation and then compared using Analysis of Variance (ANOVA) test. Linear regression analysis was also used to assess the correlation. Results: Most 125 (52%) of the women belonged to the younger age group i.e., 21-25 years. Majority i.e., 114 (47.5%) of pregnant women were primigravida. Mean total thyroid volume in non pregnant group, 1st trimester group, 2nd trimester group and in 3rd trimester group were 5.44±0.82 mL, 5.85±0.64 mL, 6.25±0.67 mL and 7.24±1.16 mL, respectively, with up to 24% increase of thyroid volume during the course of pregnancy (p-value=0.001). Thyroid nodule incidence was 12.2% in pregnant women and 5% in non pregnant women. Conclusion: With pregnancy, there is an increase in thyroid gland size along with a small increase in thyroid nodularity. Also, the interplay of a few factors such as Body Mass Index (BMI), parity, age etc., was noted. [ABSTRACT FROM AUTHOR]

Aim: To assess the accuracy of metastasis in cervical nodes using preoperative palpation method, ultrasonography with colour doppler (USG) and computed tomography (CT) in oral squamous cell carcinoma. Methodology: Thirty‐one biopsy‐proven patients with OSCC who fulfilled the inclusion and exclusion criteria were included in the study. The nodal status of each was assessed by clinical palpation, USG and CT and compared with the post‐operative histopathological result. The results were evaluated statistically for sensitivity, specificity, positive predictive value and negative predictive value and accuracy. Results: The accuracy of clinical palpation, USG and CT in diagnosing a node as metastatic was 70.9%, 100% and 87%, respectively, showing ultrasonography to be better than CT, followed by CT and clinical palpation. Conclusion: The accuracy and sensitivity of USG in the detection of cervical lymph node metastases make it a potentially promising and cheap preoperative tool for staging neck node metastases. [ABSTRACT FROM AUTHOR]

Coronary arteries (CA) in the fetal heart are seen very rarely. However, due to the introduction of the latest ultrasound technology, they can be seen in the late third trimester of pregnancy, regardless of the heart anatomy. Fetal haemodynamics can be analysed during fetal echocardiography not only in fetuses with fetal growth restriction, but also in normal fetal growth. Visualization of fetal coronary artery flow may have a temporary nature and therefore may suggest possible fetal heart compensation mechanisms. In the case of visualization of coronary artery by colour Doppler, pulse wave Doppler is recommended for the analysis of maximal velocity and direction of blood flow. [ABSTRACT FROM AUTHOR]

Introduction: Continuous stimulation of thyroid gland occurs during pregnancy in order to meet the demands of growing foetus. This might result in variations in thyroid gland morphology which may be misdiagnosed if not assessed accurately. Ultrasonography can measure these variations during pregnancy in the form of change in volume, echotexture, nodularity etc. Aim: To compare the thyroid volume and nodules using ultrasound, amongst different trimesters of pregnancy and with non pregnant women of similar age and find the correlation with different factors. Materials and Methods: A time-bound, hospital-based, cross-sectional observational study was done in the Department of Radiodiagnosis, Maharaja Yeshwantrao (MY) Hospital, Indore, Madhya Pradesh, India, from April 2021 to August 2022 on 240 patients. All subjects were divided into groups of 60 women each, which included non pregnant women in group 1 and pregnant women during each trimester in rest three groups, as group 2, 3 and 4, respectively. Thyroid volume and nodules were measured in each group. The descriptive data was calculated using mean and standard deviation and then compared using Analysis of Variance (ANOVA) test. Linear regression analysis was also used to assess the correlation. Results: Most 125 (52%) of the women belonged to the younger age group i.e., 21-25 years. Majority i.e., 114 (47.5%) of pregnant women were primigravida. Mean total thyroid volume in non pregnant group, 1st trimester group, 2nd trimester group and in 3rd trimester group were 5.44±0.82 mL, 5.85±0.64 mL, 6.25±0.67 mL and 7.24±1.16 mL, respectively, with up to 24% increase of thyroid volume during the course of pregnancy (p-value=0.001). Thyroid nodule incidence was 12.2% in pregnant women and 5% in non pregnant women. Conclusion: With pregnancy, there is an increase in thyroid gland size along with a small increase in thyroid nodularity. Also, the interplay of a few factors such as Body Mass Index (BMI), parity, age etc., was noted.

Introduction: In this era of digitalism, mobile phones have become a cultural accessory. Frequent smartphone usage results in possible adverse effects from low radiofrequency radiation and thermal effect emitted by these devices. One of the major concerns is salivary glands as the mobile phones are held against the side of face in close proximity to these glands. Aim: To assess the effect of cell phone radiation on the volume, systolic velocity, salivary flow rate of parotid and submandibular gland between the dominant and non dominant side of mobile phone users. Materials and Methods: A cross-sectional study was conducted in the Department of Oral Medicine and Radiology with the sample size of 100 (50 males and 50 females). Inclusion criteria were based on the frequency of mobile phone usage of more than two hours per day. Mobile phone usage was determined based on patient's answer to the questionnaire. Ultrasonography (USG) of both parotid and submandibular gland was done bilaterally to measure the volume of the glands and Colour Doppler of external carotid artery to measure systolic velocity. Modified Schirmer tear strips were used bilaterally to measure unstimulated salivary flow rate. The data was entered into MS excel and significance was calculated using independent sample t-test. Results: In parotid gland, mean volume, mean systolic velocity and mean salivary flow rate were of higher value in the dominant side (14.22±2.17 mL; 15.14±3.74 cm/s; 0.37±0.26 mm/5 mins) compared to the non dominant side (13.76±2.14 mL; 14.53±3.39 cm/s; 0.24±0.2 mm/5 mins). In submandibular gland, mean volume, mean systolic velocity and mean salivary flow rate were of higher value in the dominant side (9.60±1.96 mL; 15.70±6.44 cm/s; 0.30±0.22 mm/5 mins) compared to the non dominant side (8.88±2.17 mL; 13.87±4.83 cm/s; 0.26±0.21 mm/5 mins). Conclusion: The volume, systolic velocity of blood flow, the salivary flow rate, of the parotid gland and submandibular gland were significantly more on the dominant side than the non dominant side of mobile phone usage. The study emphasised that prolonged mobile phone usage causes biological changes in salivary glands and its flow rate. [ABSTRACT FROM AUTHOR]

Introduction: Cervical nodes form one of the major groups of Lymph Nodes (LN) that are frequently involved in inflammatory and neoplastic diseases. Metastasis causes the most apparent change in consistency of the node among the various nodal pathologies. Ultrasound elastography provides an estimate of tissue consistency by measuring the degree of distortion under the application of an external force. Aim: To estimate the diagnostic accuracy of sonoelastography in the differentiation of malignant and benign cervical LN with Fine Needle Aspiration Cytology (FNAC)/biopsy considered as a gold standard. Materials and Methods: A cross-sectional study was carried out from March 2020 to January 2021 in a tertiary care hospital in south India, a total of 50 patients with cervical lymphadenopathy underwent ultrasonography followed by elastography of superficial neck LN using high frequency linear transducer by freehand technique. The ultrasound characteristics of selected LN were determined and colour elastogram pattern was assessed using colour mapping elastography. The Chi-square test was performed. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were obtained. The results were then compared to the fine needle aspiration cytology. Results: A total of 50 subjects (median age of 40.5±18.71 years; 19 (38%) males and 31 (62%) females). The grayscale and colour Doppler features of cervical LN which helped predict malignancy were short axis ≥8 mm, Short:Long axis diameter ratio (S:L) ≥0.5, absence of normal central fatty hilum, abnormal echogenicity, lobulated border, presence of calcification and peripheral/mixed vascularity. With reference to the above variables of cervical LN characterisation on grayscale, colour doppler ultrasound and sonoelastography findings, elastography pattern was the most promising variable to differentiate malignant from benign cervical LN with 95.2% sensitivity, 75.0% specificity, 95.2% PPV, 75.0% NPV and 92.0% accuracy. Conclusion: Sonoelastography is useful in the assessment of elastic properties of cervical LN with short examination time required, real-time display, immediate interpretation and limited cost. Sonoelastography had higher diagnostic accuracy than gray scale and doppler ultrasound in differentiating benign from malignant cervical LN. Sonoelastography is an effective supplement to conventional gray scale and colour doppler ultrasound and that the combination is clinically recommended for a more accurate diagnosis of metastatic LN.

Abstract Background Upper extremity deep vein thrombosis (UEDVT) is an uncommon disease but has to be carefully considered in patients with isolated unilateral upper limb swelling due to its potential to cause devastating complications and sequelae such as pulmonary embolism and septic thrombophlebitis. Given the extreme rarity of this condition, it is not surprising that point-of-care ultrasonographic evaluation of the upper limb for deep venous thrombosis is hardly ever performed in the emergency department. This case report serves to highlight how point-of-care ultrasonographic evaluation of the upper extremity venous system could be incorporated as a tool in the diagnostic armamentarium of the emergency physician. Case presentation A 51-year-old Chinese gentleman presented to the emergency department with a 1-day duration of progressive right upper extremity swelling and pain. On examination, his hemodynamic parameters were stable with no tachycardia. He was noted to have a hyperaemic and grossly swollen but non-tender right upper limb. Distal pulses remained strong. Point-of-care ultrasonography of his right upper limb venous system with Doppler colour flow and single-point augmentation with the arm squeeze manoeuvre immediately confirmed the diagnosis of right upper extremity deep venous thrombosis, which in turn permitted anticoagulation to be instituted promptly whilst in the emergency department. Conclusion The use of point-of-care ultrasonography of the upper limb venous system can prove invaluable as a rapid, non-invasive technique to facilitate expedient diagnosis of and early intervention for UEDVT in the emergency department.

Introduction: In this era of digitalism, mobile phones have become a cultural accessory. Frequent smartphone usage results in possible adverse effects from low radiofrequency radiation and thermal effect emitted by these devices. One of the major concerns is salivary glands as the mobile phones are held against the side of face in close proximity to these glands. Aim: To assess the effect of cell phone radiation on the volume, systolic velocity, salivary flow rate of parotid and submandibular gland between the dominant and non dominant side of mobile phone users. Materials and Methods: A cross-sectional study was conducted in the Department of Oral Medicine and Radiology, Government Dental College and Hospital, Kadapa, Andhra Pradesh, India, from September to November 2021. The sample size of 100 (50 males and 50 females). Inclusion criteria were based on the frequency of mobile phone usage of more than two hours per day. Mobile phone usage was determined based on patient’s answer to the questionnaire. Ultrasonography (USG) of both parotid and submandibular gland was done bilaterally to measure the volume of the glands and colour doppler of external carotid artery to measure systolic velocity. Modified Schirmer tear strips were used bilaterally to measure unstimulated salivary flow rate. The data was entered into MS excel and significance was calculated using independent sample t-test. Results: In parotid gland, mean volume, mean systolic velocity and mean salivary flow rate were of higher value in the dominant side (14.22±2.17 mL; 15.14±3.74 cm/s; 0.37±0.26 mm/5 mins) compared to the non dominant side (13.76±2.14 mL; 14.53±3.39 cm/s; 0.24±0.2 mm/5 mins). In submandibular gland, mean volume, mean systolic velocity and mean salivary flow rate were of higher value in the dominant side (9.60±1.96 mL; 15.70±6.44 cm/s; 0.30±0.22 mm/5 mins) compared to the non dominant side (8.88±2.17 mL; 13.87±4.83 cm/s; 0.26±0.21 mm/5 mins). Conclusion: The volume, systolic velocity of blood flow, the salivary flow rate, of the parotid gland and submandibular gland were significantly more on the dominant side than the non dominant side of mobile phone usage. The study emphasised that prolonged mobile phone usage causes biological changes in salivary glands and its flow rate.

Purpose: The aim of the prospective study was to assess changes during treatment and prognostic significance of cervical vascularization density in patients with cervical squamous cell carcinoma (SCC) staged II B and III B and to find relationship of cervical vascularization density with tumour diameter, grading, staging and age of patients. Methods: The study group included 50 patients who underwent transvaginal Doppler ultrasonography prior to chemoradiotherapy, after external beam radiation therapy (EBRT) and 6 weeks after HDR brachytherapy. The colour Doppler (CD) vascularity index (CDVI) and the power Doppler (PD) vascularity index (PDVI) in cervical tumour were examined. Results: CDVI and PDVI values decreased significantly during radiotherapy (0.13 (95% CI 0.09–0.16); 0.09 (95% CI 0.07–0.11) and 0.05 (95% CI 0.03–0.06) for CDVI (p < 0.001) and 0.26 (95% CI 0.22–0.31); 0.18 (95% CI 0.14–0.22) and 0.08 (95% CI 0.06–0.11) for PDVI (p < 0.001)). No statistically significant associations of CDVI and PDVI with tumour diameter, grading, staging and age of patients were found. The higher (above median) CDVI values before EBRT were associated with better OS (p = 0.041). The higher (above median) PDVI values before EBRT were associated with superior DFS (p = 0.011) and OS (p < 0.001). DFS and OS did not differ significantly regarding CDVI and PDVI values after EBRT and after the treatment. Conclusions: In the study group, cervical vascularization density evaluated in CD and PD functions did not depend on tumour diameter, grading, staging and age of patients and decreased during radiotherapy. The prognosis for our patients with CDVI and PDVI before the treatment above the median value was better than compared to patients with these parameters below the median value. [ABSTRACT FROM AUTHOR]

Introduction: Testicular diseases in children include hernia, hydrocele, undescended testis, epididymal cyst or torsion testis. Some of these like hernia and undescended testis will have affect on the testicular volume and blood flow. These are predictors for the future function of the testis. Manipulations during surgery can also affect blood flow to the testis. Aim: To compare testicular volume and blood flow in children undergoing surgery for inguinoscrotal diseases in both normal and diseased sides, before and after surgery. Materials and Methods: A prospective cohort study was conducted from March 2019 to December 2019 in which 30 children were selected from Surgery Outpatient Department (OPD), Department of Paediatrics, Gian Sagar Medical College, Rajpura, Punjab, India. For patients having inguinoscrotal disease, ultrasonography (US) and colour doppler was done preoperatively on all cases by an experienced radiologist, using the same machine settings on the seventh day and three months postsurgery. Preoperative and postoperative testicular volume and blood flow was recorded in all the patients. The Statistical Package for Social Sciences (SPSS) software was used to statistically analyse the data arising, p0.05). The increase in mean blood flow of diseased testis was significant after seven days of surgery (p-value

Introduction: Most common metastasis site for breast carcinoma in axillary lymph nodes. Lymph nodes of the axilla metastasis are one of the reliable and vital prognostic factors in subjects with breast cancer. Early and accurate differentiation of benign axillary lymph nodes from malignant lymph nodes is vital to prevent the conversion of treatable lesions to an incurable one and for improved survival and outcomes. Aims: The present study was conducted to assess axillary lymph nodes in subjects with breast carcinoma on strain wave elastography, color doppler, and greyscale ultrasound and to correlate them histopathologically. Also, the present study compared the negative and positive predictive values, specificity, and sensitivity of combined greyscale ultrasound and elastography findings to findings of greyscale ultrasound. Materials and Methods: In 68 subjects with a confirmed diagnosis of carcinoma breast on histopathology were evaluated for axillary lymph nodes assessed for cortical thickness/fatty hilum thickness ratio (C/F ratio), cortical thickness, long/short axis ratio (L/S ratio), presence/absence of hilum, shape, and size on color doppler for vascularity, greyscale ultrasound, and elastography. The diagnosis was made and was confirmed on histopathology. Results: It was seen that malignancy was favored by increased C/F ratio, decreased L/S ratio, increased cortical thickness, eccentric/compressed or absent hilum, irregular nodular margins, and round shape in morphology. Differentiation from benign to malignant lymph nodes was done based on peak systolic velocity/end-diastolic velocity ratio, resistivity index, and vascular flow pattern type. In malignant lymph nodes, the mean strain ratio was higher than benign lymph nodes. Conclusions: The present study concludes that ultrasound including strain elastography, color Doppler, and greyscale ultrasound should be routinely included in the initial screening of subjects with breast carcinoma owing to its advantages of being accurate, easy accessibility, radiation-free nature, and cost-effectiveness. [ABSTRACT FROM AUTHOR]

Background: Upper extremity deep vein thrombosis (UEDVT) is an uncommon disease but has to be carefully considered in patients with isolated unilateral upper limb swelling due to its potential to cause devastating complications and sequelae such as pulmonary embolism and septic thrombophlebitis. Given the extreme rarity of this condition, it is not surprising that point-of-care ultrasonographic evaluation of the upper limb for deep venous thrombosis is hardly ever performed in the emergency department. This case report serves to highlight how point-of-care ultrasonographic evaluation of the upper extremity venous system could be incorporated as a tool in the diagnostic armamentarium of the emergency physician. Case presentation: A 51-year-old Chinese gentleman presented to the emergency department with a 1-day duration of progressive right upper extremity swelling and pain. On examination, his hemodynamic parameters were stable with no tachycardia. He was noted to have a hyperaemic and grossly swollen but non-tender right upper limb. Distal pulses remained strong. Point-of-care ultrasonography of his right upper limb venous system with Doppler colour flow and single-point augmentation with the arm squeeze manoeuvre immediately confirmed the diagnosis of right upper extremity deep venous thrombosis, which in turn permitted anticoagulation to be instituted promptly whilst in the emergency department. Conclusion: The use of point-of-care ultrasonography of the upper limb venous system can prove invaluable as a rapid, non-invasive technique to facilitate expedient diagnosis of and early intervention for UEDVT in the emergency department. [ABSTRACT FROM AUTHOR]

Background: The sonographic characteristics of frontal fibrosing alopecia have been scarcely studied. The aim of this study was to perform a colour Doppler ultrasound evaluation in frontal fibrosing alopecia. Materials and methods: A cross‐sectional study including 99 women with frontal fibrosing alopecia and 40 control subjects was performed using ultrasound equipment with a lineal 18 MHz probe. Three areas were evaluated per patient: the alopecic area (a), the hairline implantation area (b) and healthy scalp (c). The diameter (cm) and flow (m/s) of the two most significant vessels were recorded. Results: With regard to the hairline implantation area, patients presented higher vessel diameter (0.127 cm vs 0.103 cm, P =.03) and vessel flow (8.183 m/s vs 7.670 m/s, P =.05) than the control group. Vessel diameter was higher in the healthy scalp area in patients than in the control group (0.088 cm vs 0.078 cm, P =.03). Conclusion: Patients presented higher vessel diameter and flow in the hairline implantation area compared to the control group. [ABSTRACT FROM AUTHOR]

Introduction: Although transrectal ultrasound is routinely performed for imaging prostate lesions, colour Doppler imaging visualizing vascularity is not commonly used for diagnosis. The goal of this study was to measure vascular and echogenic differences between malignant and benign lesions of the prostate by quantitative colour Doppler and greyscale transrectal ultrasound. Methods: Greyscale and colour Doppler ultrasound images of the prostate were acquired in 16 subjects with biopsy-proven malignant or benign lesions. Echogenicity and microvascular flow velocity of each lesion were measured by quantitative image analysis. Flow velocity was measured over several cardiac cycles and the velocity–time waveform was used to determine microvascular pulsatility index and microvascular resistivity index. The Wilcoxon rank sum test was used to compare the malignant and benign groups. Results: Median microvascular flow velocity of the malignant lesions was 1.25 cm/s compared to 0.36 cm/s for the benign lesions. Median pulsatility and resistive indices of the malignant lesions were 1.55 and 0.68, respectively versus 6.38 and 1.0 for the benign lesions. Malignant lesions were more hypoechoic relative to the surrounding tissue, with median echogenicity of 0.24 compared to 0.76 for the benign lesions. The differences between the malignant and benign groups for each measurement were significant (p < 0.01). Conclusion: Marked differences were observed in flow velocity, microvascular pulsatility, microvascular resistance, and echogenicity of prostate cancer measured with quantitative colour Doppler and greyscale ultrasound imaging. Vascular differences measured together with echogenicity have the combined potential to characterize malignant and benign prostate lesions. [ABSTRACT FROM AUTHOR]

Aims: To compare the diagnostic performance of microvascular Doppler ultrasonography (MVUS) to B-mode and con-ventional colour Doppler US (CDUS) for detecting acute pyelonephritis (APN) lesions in children.Material and Methods: An IRB-approved retrospective study was performed. From July 2018 to January 2019, 41 APN lesions in 28 children (15 boys, 13 girls; age range, 1-196 months; mean age, 53 months) who underwent 99mTc‒dimercaptosuccinic acid renal scintig-raphy (DMSA) or contrast-enhanced computed tomography (CECT) and US including B-mode, CDUS, and MVUS were enrolled in this study. Three paediatric radiologists independently reviewed the B-mode, CDUS and MVUS images for the DMSA or CECT-proven APN lesions and evaluated the lesion visibility, lesion distinguishability and diagnostic confidence between the MVUS and CDUS images.Results: A total 41 of APN lesions were verified by DMSA (41 lesions) or CECT (3 lesions) during the same hospitalization period with renal US. Among 41 APN lesions, 52.8% was visible on B-mode, 85.4% on CDUS, and 94.3% on MVUS (p<0.001). Comparing the extent and margins of the lesions, MVUS had better results than CDUS in 41.5% of the lesions, CDUS had better results in 6.5% and they were equal in 52% (p<0.001). The diagnostic con-fidence of the APN lesions was higher for MVUS than CDUS in 36.6%, higher for CDUS than MVUS in 4.9%, and equal in the remaining 58.5% (p<0.05). The interobserver agreement was fair to moderate.Conclusions: MVUS showed improved detectability of hypoperfused areas in paediatric APN and provided higher diagnostic confidence. [ABSTRACT FROM AUTHOR]

Vein of Galen aneurysmal malformation (VGAM) is a rare vascular anomaly originating during embryonic development, specifically between the 6th and 11th weeks of gestation. This malformation results from abnormal arteriovenous connections between primitive choroidal arteries and the median prosencephalic vein (MPV) of Markowski. Typically, the MPV regresses by the 11th week, but in VGAM, this regression is hindered, leading to persistent abnormal flow and the formation of arteriovenous shunts. We present a case of successful prenatal detection, as well as a comprehensive literature review that summarizes current knowledge, emphasizes the importance of prenatal detection, detailed imaging techniques, understanding clinical presentations, and outlines treatment options. Prenatal detection, crucial for early intervention, has become feasible through ultrasonography and MRI. Fetal MRI has emerged as the gold standard, offering detailed insights into arterial feeders, nidus presence, fistula position, venous drainage, and potential complications. The clinical presentation of VGAM varies with age, and neonates diagnosed in utero may exhibit signs of high-output cardiac failure. Early detection is critical for timely intervention, as untreated VGAMs often result in high mortality rates. Prognosis depends on the severity of heart failure, the number of arteriovenous shunts, and the presence of accompanying fetal abnormalities. Various imaging modalities, including CT angiography and digital subtraction angiography (DSA), aid in the assessment and treatment of VGAM. DSA remains the gold standard for evaluating angioarchitecture and guiding endovascular interventions. The optimal treatment for VGAM is transarterial embolization, offering significant improvements in prognosis. Surgical interventions are limited due to high morbidity and mortality. Management decisions should consider the balance between minimizing neurological damage and achieving maximum embolization effectiveness., Competing Interests: none., (© 2024 Published by Elsevier B.V.)

Splenic abscess is an uncommon condition encountered with an incidence of around 0.1-0.7%. The most common cause of infection of the spleen is usually from the hematogenous route resulting from endocarditis or seeding from sites of infection. Splenic abscess is unusual and mostly involves the splenic vessels. The diagnosis is often missed due to lack of or non-specific clinical symptoms. Authors present a rare case scenario of a 50-year-old female patient who presented with pain in abdomen. On examination, there was tenderness in left hypochondrium region along with splenomegaly. Ultrasonography (USG) abdomen-pelvis revealed splenic abscess. Since patient had raised WBC count and Random Blood Sugar (RBS), she was started on antibiotics and hyperglycaemic management was started. USG guided Percutaneous Drainage (PCD) of the abscess was done. Contrast Enhanced Computed Tomography (CECT) abdomen-pelvis showed splenic abscess with drainage catheter in-situ and thrombosis in abdominal aorta involving the right renal artery causing renal infarcts. Patient’s bilateral lower limb Colour Doppler test revealed decreased arterial flow in right lower limb. Prothrombin time was deranged, thus anti-platelets were started and which was later shifted onto oral anti-coagulant therapy. Successive USGs revealed resolution of the abscess, so PCD was removed. Right kidney showed vascularity and no thrombosis was noted in aorta. Due to singular nature of the splenic abscess and early detection of thrombus on CT scan, the present case responded well to PCD and conservative management, which lead to complete resolution of abscess and prevented the likely complications of thrombosis.

Introduction: Splenogonadal fusion is a rare developmental disorder that results in a gonadal or paragonadal mass due to the close proximity of the developing spleen and gonad. Case report: We describe a case of splenogonadal fusion presenting as a paratesticular mass in a 25-year-old male. This was ultimately diagnosed on surgical biopsy. Discussion: Splenogonadal fusion is a rare abnormality but can be managed conservatively. The sonographic features and the differential diagnosis are highlighted. Conclusion: Through this case, we highlight the clinical and sonographic features of splenogonadal fusion. Awareness amongst ultrasound practitioners is important, given that it can be managed conservatively, and means of a non-invasive diagnosis are highlighted. [ABSTRACT FROM AUTHOR]

Background: Colour duplex Doppler is a noninvasive tool for the evaluation of the vascular mechanism of erectile dysfunction (ED). It can be used to determine the integrity of the vascular mechanism and to differentiate between arterial and venous insufficiency., Objectives: To identify the vasculogenic causes of ED and subclassify them into arteriogenic, venogenic, or mixed to assist in predicting the clinical outcome., Materials and Methods: A retrospective study was conducted at the Department of Radiology, ABUTH Zaria, from records of patients who had presented to the Doppler suite with symptoms of ED available between July 2020 and August 2022., Results: A total of 23 patients were involved in this study. The age range was 25-66 years. The majority of the patients were seen in age groups 51-60 years and 41-50 years with 48% (11) and 22% (5), respectively. Only 3 (13%) of the patients were found to have normal penile Doppler study, 12 (52%) patients were found to have arteriogenic, and another 4 (17.4%) patients were found to have venogenic cause. In four (17.4%) patients, there was mixed/inconclusive picture. Among the nine (39%) patients with Peyronie's disease, only one showed normal Doppler study. The incidence of vasculogenic cause of ED was found to increase with age., Conclusions: The colour Doppler study is an important noninvasive nonionizing radiation tool for swift evaluation of penile erectile function and, thus, helps in classifying ED causes into structural, vascular, or possibly psychogenic, hence guiding the clinicians on the therapeutic options., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of the west African college of surgeons.)

The study was performed in a prospective randomized fashion in order to compare the value of tansvaginal ultrasound, and the value of combined colour Doppler imaging of uterine, ovarian blood flow and transvaginal folliculometry in assessment of ovulation induction of infertile women. Ovulation rate was taken as the gold standard for assessment of ovulation induction result Analysis of the results provided the following information: A) Better sensitivity & specificity of colour Doppler indices in detection of ovulation. B) Better timing of human chorionic gonadotrophin administration & better ovulation rate when colour Doppler was used in cycle monitoring. It can be concluded from the results of this study that combined use of transvaginal sonography& colour Doppler imaging is more reliable in assessment of ovulation & is more useful in monitoring of follicular growth and vascularity in clomiphene citrate induced cycles than the use of transvaginal ultrasound alone. The study opens a new field of ongoing research on the valuable application of colour Doppler studies in the management of gynecologic infertility due to ovarian cause. [ABSTRACT FROM AUTHOR]

Contents: Testicular tumours are the most common neoplasms in male dogs accounting for approximately 90% of all tumours affecting the genitourinary tract. Gray‐scale ultrasonography in combination with colour and power Doppler imaging has been well accepted as an accurate technique for assessing scrotal lesions and vascularization of the testis. Colour Doppler sensitivity for low blood flows appears promising in the study of testicular disorders. The aim of this study was to assess if colour and power Doppler ultrasound is a good tool for the investigation of testicular lesions in dogs, to report the sonographic features of lesions and to measure colour and power Doppler parameters such as resistive index (RI), pulsatility index (PI), hypovascularization and hypervascularization (VI) determining if they can be used to distinguish testicular neoplasms from the wide spectrum of non‐neoplastic pathological findings. In this study, 50 male dogs of various breeds, aged between 7 and 14 years, presented with testicular disorders were selected. RI and PI were calculated. Mean RI values for neoplastic, inflammatory and degenerative lesions were 0.54, 0.45 and 0.58, respectively. Mean PI values were 0.62, 0.55 and 0.63, respectively. Hypovascularization and hypervascularization of the lesion were evaluated throughout the vascularity index (VI). Vascular signals in neoplasms were significantly intensified around and inside the mass if compared with those measured during inflammatory and degenerative lesions. VI markedly increased in solid tumours. Pathological testes were removed; macroscopical, histological and immunoistochemical evaluations were carried out. Colour Doppler showed increased intralesional and peripheral flows in all neoplastic lesions analysed. No flows were detected around cysts. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of high-resolution ultrasound and colour Doppler in differentiating neoplastic and nonneoplastic causes of cervical lymphadenopathy compared to histopathological diagnosis. Study Design: Cross-Sectional study. Place and Duration of Study: Pakistan Institute of Medical Sciences, Islamabad Pakistan, from Jan to Jun 2019. Methodology: The study included 110 patients with palpable cervical lymph nodes undergoing neck ultrasound and Fine needle aspiration cytology/Biopsy. Certain important sonological features were considered to categorize them into nonneoplastic and neoplastic groups. Colour Doppler imaging was employed along with grey-scale imaging. The histopathology results were compared with sonographic findings to determine the diagnostic accuracy of ultrasound in differentiating neoplastic from non-neoplastic causes of enlarged cervical lymph nodes. Results: Our study revealed that High-resolution sonography has 94.4% sensitivity and 88.8% specificity, differentiating between neoplastic and non-neoplastic causes of cervical lymphadenopathy. At the same time, the overall accuracy of ultrasound is 90.9%. The most consistent grey-scale feature in the non-neoplastic nodal group was preserved central fatty hilum, while its loss was significantly associated with neoplastic etiologies. Conclusion: Due to high sensitivity and negative predictive value, high-resolution sonography can be deployed as a first-line investigating tool for enlarged lymph nodes, and invasive procedures like Fine needle aspiration cytology (FNAC) can be abandoned in non-neoplastic lymphadenopathies. [ABSTRACT FROM AUTHOR]

Mild systolic reduction in pulmonary artery flow is an echocardiographic sign of pulmonary artery hypertension. However, at times, it is difficult to appreciate and further grade it into mild, moderate, or severe. We regularly performed color Doppler and color M-mode echocardiography of pulmonary flow and observed that it is easier to interpret and grade the findings. Findings correlate with pulmonary artery pressure evaluated by tricuspid regurgitation jet. Four representative examples are presented.